Ben-Haim S, Seabold J E, Kao S C, Johnson J, Tran D, Brown B P
Department of Radiology, University of Iowa College of Medicine, Iowa City, USA.
Clin Nucl Med. 1995 Feb;20(2):153-63. doi: 10.1097/00003072-199502000-00012.
Technetium-99m mebrofenin hepatobillary excretory patterns were assessed in 36 infants with hyperbilirubinemia. Phenobarbital was administered to 22 patients before imaging. Final diagnoses included: intrahepatic cholestasis (14 patients), neonatal hepatitis (nine patients), biliary atresia (eight patients), alpha-1-antitrypsin deficiency (two patients), Alagille's syndrome (two patients), and cystic fibrosis (one patient). No patient with biliary atresia showed bowel activity by 24 hours. Of the 28 infants without biliary atresia, 23 (82%) had bowel activity visualized by 6-8 hours and 26 (90%) had bowel activity by 24 hours. Two had no bowel activity at 24 hours: one had cystic fibrosis and one had neonatal hepatitis. Of the 26 patients with bowel visualization, the time to visualize bowel did not differ between patient groups with and without phenobarbital induction. All of the patients with hepatitis, including those with marked dysfunction, showed good hepatic uptake. Mebrofenin scintigraphy is an important imaging technique in the diagnostic evaluation of infants with hyperbilrubinemia. In addition to biliary atresia, intrahepatic cholestasis due to cystic fibrosis and severe neonatal hepatitis may also cause bowel nonvisualization up to 24 hours. The results of this study suggest phenobarbital induction may not be needed when Tc-99m mebrofenin scintigraphy is used for the assessment of infantile jaundice.
对36例高胆红素血症婴儿进行了锝-99m美罗芬宁肝胆排泄模式评估。22例患者在成像前给予苯巴比妥。最终诊断包括：肝内胆汁淤积（14例）、新生儿肝炎（9例）、胆道闭锁（8例）、α-1抗胰蛋白酶缺乏症（2例）、阿拉吉尔综合征（2例）和囊性纤维化（1例）。没有胆道闭锁患者在24小时时显示肠道有放射性。在28例无胆道闭锁的婴儿中，23例（82%）在6 - 8小时时可见肠道放射性，26例（90%）在24小时时可见肠道放射性。2例在24小时时无肠道放射性：1例患有囊性纤维化，1例患有新生儿肝炎。在26例肠道显影的患者中，有和没有苯巴比妥诱导的患者组之间肠道显影时间没有差异。所有肝炎患者，包括那些有明显功能障碍的患者，均显示肝脏摄取良好。美罗芬宁闪烁扫描是评估高胆红素血症婴儿的重要成像技术。除胆道闭锁外，囊性纤维化和严重新生儿肝炎引起的肝内胆汁淤积也可能导致长达24小时的肠道不显影。本研究结果表明，当用锝-99m美罗芬宁闪烁扫描评估婴儿黄疸时，可能不需要苯巴比妥诱导。
