Ferretti-Cisneros M C, Fernandes M I, Galvão L C, Maciel L M, Sawamura R
Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo-FMRPUSP.
Arq Gastroenterol. 1995 Apr-Jun;32(2):85-90.
We evaluated 51 tests of 99mTc-DISIDA excretion by the biliary tree in patients with neonatal cholestasis. The aim of the present study was to verify the value of this test in the differentiation of this syndrome, correlating it to the clinical and laboratory data. The case studied were divided into two groups: extrahepatic biliary atresia, 26 patients (50.9%) and no-extrahepatic biliary atresia, 25 patients (49.1%). Analyzing the results, we concluded that this test had 96% sensitivity, 56% specificity, 69% positive predictive value, 93% negative predictive value and 76.5% accuracy. The accuracy of this test was only lower than that of hepatic biopsy. We conclude that the hepatobiliary scintigraphy was very useful in the definition of extrahepatic biliary atresia, with less value in the group of neonatal hepatitis, perhaps due to the delayed referral of the patients, short time of the scintigraphy study or factors related to the etiology of cholestasis itself.
我们对51例新生儿胆汁淤积患者进行了99mTc-DISIDA经胆管排泄的检测。本研究的目的是验证该检测在鉴别此综合征中的价值,并将其与临床和实验室数据相关联。所研究的病例分为两组:肝外胆管闭锁26例(50.9%),非肝外胆管闭锁25例(49.1%)。通过分析结果,我们得出该检测具有96%的敏感性、56%的特异性、69%的阳性预测值、93%的阴性预测值和76.5%的准确性。该检测的准确性仅低于肝活检。我们得出结论,肝胆闪烁显像在肝外胆管闭锁的诊断中非常有用,在新生儿肝炎组中的价值较小,这可能是由于患者转诊延迟、闪烁显像研究时间短或与胆汁淤积病因本身相关的因素所致。