Noriko Tsuda1, Shinya Shiraishi2, Fumi Sakamoto2, Koji Ogasawara2, Seiji Tomiguchi3, Yasuyuki Yamashita2. 1. Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan. sdnrk1984@yahoo.co.jp. 2. Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan. 3. Department of Diagnostic Medical Imaging, School of Health Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Abstract
PURPOSE: Hepatobiliary scintigraphy plays an important role in the differentiation of biliary atresia (BA) and non-BA. The usefulness of 99mTc-iminodiacetic acid (IDA) derivatives in BA diagnosis is reported in several papers. In contrast, there are no comprehensive data on differentiating BA from non-BA using 99mTc-N-pyridoxyl-5-methyl-tryptophan (PMT). Our objective was to evaluate the usefulness of 99mTc-PMT scintigraphy in the diagnosis of BA. MATERIALS AND METHODS: 52 infants who received 99mTc-PMT scintigraphy for suspected BA were retrospectively evaluated. Preoperative cholangiograms or follow-ups were used as the gold standard for diagnosis of BA. We analyzed the utility of 99mTc-PMT scintigraphy, various clinical and investigational parameters in the diagnosis of BA. RESULTS: The final diagnoses in this group were BA (67.3%) and non-BA (32.7%). 99mTc-PMT scintigraphy, stool color change, total bilirubin, direct bilirubin, aspartate aminotransferase (AST) and γ-glutamyl transferase (γ-GTP) led to distinguishing between BA and non-BA in univariate analysis. Subsequent multivariate logistic regression analysis indicated that 99mTc-PMT scintigraphy and γ-GTP were independent predictors of BA. The diagnostic accuracy of 99mTc-PMT scintigraphy was 94.2%. CONCLUSIONS: 99mTc-PMT scintigraphy is more accurate in the diagnosis of BA than other conventional examinations. In addition, false positives of 99mTc-PMT scintigraphy could be reduced by combining γ-GTP level monitoring.
PURPOSE: Hepatobiliary scintigraphy plays an important role in the differentiation of biliary atresia (BA) and non-BA. The usefulness of 99mTc-iminodiacetic acid (IDA) derivatives in BA diagnosis is reported in several papers. In contrast, there are no comprehensive data on differentiating BA from non-BA using 99mTc-N-pyridoxyl-5-methyl-tryptophan (PMT). Our objective was to evaluate the usefulness of 99mTc-PMT scintigraphy in the diagnosis of BA. MATERIALS AND METHODS: 52 infants who received 99mTc-PMT scintigraphy for suspected BA were retrospectively evaluated. Preoperative cholangiograms or follow-ups were used as the gold standard for diagnosis of BA. We analyzed the utility of 99mTc-PMT scintigraphy, various clinical and investigational parameters in the diagnosis of BA. RESULTS: The final diagnoses in this group were BA (67.3%) and non-BA (32.7%). 99mTc-PMT scintigraphy, stool color change, total bilirubin, direct bilirubin, aspartate aminotransferase (AST) and γ-glutamyl transferase (γ-GTP) led to distinguishing between BA and non-BA in univariate analysis. Subsequent multivariate logistic regression analysis indicated that 99mTc-PMT scintigraphy and γ-GTP were independent predictors of BA. The diagnostic accuracy of 99mTc-PMT scintigraphy was 94.2%. CONCLUSIONS:99mTc-PMT scintigraphy is more accurate in the diagnosis of BA than other conventional examinations. In addition, false positives of 99mTc-PMT scintigraphy could be reduced by combining γ-GTP level monitoring.
Authors: S Matsuoka; K Uchiyama; Y Kuniyasu; Y Niio; S Hasebe; H Shima; S Oishi; Y Nojiri; H Ogata Journal: Ann Nucl Med Date: 2001-02 Impact factor: 2.668
Authors: J P Gerhold; W C Klingensmith; C C Kuni; J R Lilly; A Silverman; A R Fritzberg; T L Nixt Journal: Radiology Date: 1983-02 Impact factor: 11.105