Hepatobiliary scintigraphy with technetium-99m disofenin in the evaluation of neonatal cholestasis

K. L. Cox., R. C. Stadalnik, John P McGahan, K. Sanders, R. A. Cannon, B. H. Ruebner

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

To assess the reliability of technetium-99m disofenin scanning in evaluating neonatal cholestasis, 33 neonates (<3 months of age) with direct hyperbilirubinemia were evaluated prospectively by cholescintigraphy. Results of this test were compared to those of standard serum tests of liver function, ultrasonography, and liver biopsy. The diagnosis of biliary atresia was suggested by a serum γ-glutamyl transpeptidase (γ-GTP) >300 units/L, absence of the gallbladder on ultrasonography, and a lack of detectable radioisotope in the gastrointestinal and/or extrahepatic biliary tract on cholescintigraphy. Each of these tests lacked sensitivity and/or specificity when compared to liver biopsy. Of the nine neonates with biliary atresia, three had gallbladders identified by ultrasonography and two had γ-GTP <300 units/L. Of the 24 neonates without biliary atresia, eight had cholescintigraphy without detectable radioisotope excretion, four had ultrasonography that failed to visualize the gallbladder, and nine had γ-GTP >300 units/L. Cholescintigraphy excluded the diagnosis of biliary atresia when gut and/or extrahepatic biliary excretion of isotope was seen. However, cholescintigraphy required more time, 6-8 days, and was less specific than ultrasonography and liver biopsy. We recommend that cholescintigraphy should not be routinely used in evaluating neonatal cholestasis, especially if it delays surgical intervention.

Original languageEnglish (US)
Pages (from-to)885-891
Number of pages7
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume6
Issue number6
StatePublished - 1987

ASJC Scopus subject areas

  • Food Science
  • Medicine (miscellaneous)
  • Gastroenterology
  • Histology
  • Pediatrics, Perinatology, and Child Health

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