Tc-99m PMT scintigraphy in the diagnosis of pediatric biliary atresia
| Autor: | Yasuyuki Yamashita, Noriko Tsuda, Koji Ogasawara, Seiji Tomiguchi, Fumi Sakamoto, Shinya Shiraishi |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pyridoxal Bilirubin Direct bilirubin Scintigraphy 030218 nuclear medicine & medical imaging Diagnosis Differential 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Liver Function Tests Biliary Atresia Biliary atresia medicine Humans Radiology Nuclear Medicine and imaging Medical diagnosis Radionuclide Imaging Retrospective Studies Tc-99m-PMT Univariate analysis medicine.diagnostic_test business.industry Infant Newborn Tryptophan Infant Reproducibility of Results Organotechnetium Compounds Gold standard (test) medicine.disease chemistry 030220 oncology & carcinogenesis Female Radiopharmaceuticals business Nuclear medicine |
| Zdroj: | Japanese Journal of Radiology. 37:841-849 |
| ISSN: | 1867-108X 1867-1071 |
| Popis: | 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. 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. 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%. 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. |
| Databáze: | OpenAIRE |
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