Objective: To evaluate the value of 99mTc-EHIDA hepatobiliary scintigraphy with different Liver/Kidney ratio (LKR) in the distinguish of infant persistent jaundice.
Methods: A total of 128 patients with infant persistent jaundice (45 females, with a mean age of 45.9 ± 23.4 d) underwent hepatobiliary scintigraphy were analyzed retrospectively. All patients were underwent to detecting their level of glutamyl transpeptidase (γ-GT) before hepatobiliary scintigraphy. We drawn the outline of same size region of interest in the near right of liver (L) edge and left kidney (K) at the ten minites of hepatobiliary scintigraphy and calculated the ROI of liver to kidney ratios. The receiver operating characteristic (ROC) curve was used to analyze the threshold and calculate the sensitivity and specificity of γ-GT.
Results: The sensitivity, specificity and accuracy of hepatobiliary scintigraphy in the diagnosis of biliary atresia (BA) was 91.4% (32/35), 83.8% (78/93) and 85.9% (110/128), respectively. The LKR of (BA) group were slightly higher than infantile hepatitis syndrome (IHS) group (t2.23P<0.05). The LKR of between BAand BA and between IHS and HIShave no statistics significance (P>0.05, t1.17, 1.29, respectively). The AUC of serum γ-GT in diagnosis of BA is 0.87 according to the ROC curve, and the sensitivity and specificity of BA is 0.91 and 0.71, respectively. The accuracy of both methods was 91.5% when the LKR and γ-GT were combined to diagnosing the BA.
Conclusions: The 99mTc-EHIDA dynamic hepatobiliary scintigraphy has unique advantages in the differential diagnosis of persistent jaundice in infants. The comprehensive analysis of LKR combined with serum γ-GT can obvious improve the diagnosis value for persistent jaundice in infants.