Kirks D R, Coleman R E, Filston H C, Rosenberg E R, Merten D F
AJR Am J Roentgenol. 1984 Mar;142(3):461-5. doi: 10.2214/ajr.142.3.461.
Fifteen patients with persistent neonatal jaundice were evaluated by sonography and radionuclide scintigraphy. The sonographic features of both neonatal hepatitis and biliary atresia are nonspecific. Hepatobiliary scintigraphy after phenobarbital pretreatment in patients with neonatal hepatitis demonstrates normal hepatic extraction and delayed tracer excretion into the gastrointestinal tract. If there is neonatal hepatitis with severe hepatocellular damage, the hepatic extraction of tracer activity is decreased and excretion may be delayed or absent. Patients under 3 months of age with biliary atresia have normal hepatic extraction of tracer with no excretion into the gastrointestinal tract. Sonography in patients with a choledochal cyst shows a cystic mass in the porta hepatis with associated bile-duct dilatation. Hepatobiliary scintigraphy confirms that the choledochal cyst communicates with the biliary system. Initial sonography demonstrates hepatobiliary anatomy; subsequent phenobarbital-enhanced radionuclide scintigraphy determines hepatobiliary function. An expedient diagnostic approach is recommended for the evaluation of persistent neonatal jaundice.
对15例持续性新生儿黄疸患者进行了超声检查和放射性核素闪烁扫描。新生儿肝炎和胆道闭锁的超声特征均无特异性。经苯巴比妥预处理后，新生儿肝炎患者的肝胆闪烁扫描显示肝脏摄取正常，示踪剂排泄延迟至胃肠道。如果是伴有严重肝细胞损伤的新生儿肝炎，示踪剂活性的肝脏摄取会减少，排泄可能延迟或无排泄。3个月以下患有胆道闭锁的患者肝脏对示踪剂的摄取正常，但无示踪剂排泄至胃肠道。胆总管囊肿患者的超声检查显示肝门处有囊性肿块，并伴有胆管扩张。肝胆闪烁扫描证实胆总管囊肿与胆道系统相通。初始超声检查可显示肝胆解剖结构；随后的苯巴比妥增强放射性核素闪烁扫描可确定肝胆功能。对于持续性新生儿黄疸的评估，建议采用一种便捷的诊断方法。
