Lin W Y, Lin C C, Changlai S P, Shen Y Y, Wang S J
Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan.
Pediatr Surg Int. 1997;12(1):30-3. doi: 10.1007/BF01194798.
Technetium Tc-99m disofenin cholescintigraphy (CS) and ultrasonography (US) are two major clinical methods used in differentiating biliary atresia (BA) from neonatal jaundice. To compare the diagnostic utility of these two modalities, 66 patients with neonatal cholestasis (15 BA, 3 choledochal cyst (CC), 32 neonatal hepatitis, 13 prolonged jaundice, 2 total parenteral nutrition, and 1 sepsis) underwent Tc-99m disofenin CS and US. The diagnostic sensitivity, specificity, and accuracy of CS in differentiating BA from other forms of neonatal jaundice was 100%, 87.5%, and 90.5%, respectively, and for US 86.7%, 77.1%, and 79.4%, respectively. Tc-99m disofenin CS after premedication with phenobarbital and cholestyramine is a convenient and reliable method of differentiating BA from neonatal hepatitis, with a diagnostic accuracy superior to that of US. However, US is the initial imaging procedure of choice in patients presenting with jaundice to rule out anatomic anomalies such as CC.
锝 Tc-99m 二异丙基乙酰胺胆管闪烁显像（CS）和超声检查（US）是用于鉴别胆道闭锁（BA）与新生儿黄疸的两种主要临床方法。为比较这两种检查方式的诊断效用，66 例新生儿胆汁淤积患者（15 例 BA、3 例胆总管囊肿（CC）、32 例新生儿肝炎、13 例持续性黄疸、2 例全胃肠外营养和 1 例败血症）接受了锝 Tc-99m 二异丙基乙酰胺 CS 和 US 检查。CS 在鉴别 BA 与其他形式新生儿黄疸方面的诊断敏感性、特异性和准确性分别为 100%、87.5%和 90.5%，而 US 分别为 86.7%、77.1%和 79.4%。在使用苯巴比妥和消胆胺进行预处理后进行锝 Tc-99m 二异丙基乙酰胺 CS 是一种鉴别 BA 与新生儿肝炎的便捷且可靠的方法，其诊断准确性优于 US。然而，US 是黄疸患者排除诸如 CC 等解剖学异常的首选初始影像学检查方法。
