[Hepatobiliary scintigraphy using 99m Tc-DISIDA and obstructive cholangiopathy in children].

Technetium 99m-labeled diisopropyl iminodiacetic acid (99m Tc-DISIDA) hepatobiliary scintigraphy of 26 patients with pathologically proven infantile obstructive cholangiopathy are retrospectively studied according to two types of criteria. Those of type 1 consider 1) hepatocyte clearance 2) hepatobiliary transit time and 3) visualisation of intestinal activity. For biliary atresia, sensitivity of 88.2%, specificity of 88.9%, positive predictive value of 93.8% and negative predictive value of 80.0% were obtained. For neonatal hepatitis, those parameters were 57.1%, 94.7%, 80.0% and 85.7% respectively. Criteria of type 2 identify only biliary atresia. They consider 1) presence or absence of intestinal radioactivity through 24 hours and 2) birth weight. Sensitivity, specificity, positive and negative predictive values were 88.2%, 88.9%, 93.8% and 80.0% respectively. Even if all these values are inferior to many reported in literature, we consider that the two types of criteria are relatively sensitive and specific to detect biliary atresia. Even through there are a few false negatives, biliary scintigraphy does remain one of the most important diagnostic tests in the context of biliary atresia.