肝胆核素显像在婴幼儿黄疸鉴别诊断中显像时间终止点的探讨  

Hepatobiliary imaging in the diagnosis of prolonged neonatal jaundice:which scanning end point should be chosen?

作　　者：岳殿超[1] 凌坚[2] 冯锦兰[3] 吴可宁[1] 李春亿[1] 胡平[1] 

机构地区：[1]中山大学附属第一医院医学影像部核医学科,广州510080 [2]中山大学附属第一医院黄埔分院放射科,广州510700 [3]广州市儿童医院放射科,广州510120

出　　处：《影像诊断与介入放射学》2010年第3期177-178,共2页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨以给予核素肝胆显像剂后6h作为肝胆显像时间终止点的可能性。方法回顾性地分析178例核素肝胆显像结果。采用双盲法分析,根据给药后6和24h内的图像有无肠道放射性聚集来诊断先天性胆道闭锁。若在显像终止点肠道内仍无放射性聚集,则认为是先天性胆道闭锁导致的黄疸。结果每个观察者对于每个病例的6h以及24h的影像诊断意见均一致。观察者之间,有159例显像诊断意见一致。结论建议行肝胆核素显像进行黄疸原因鉴别诊断时,若延迟至6h仍未发现肠道有放射性存在,则进行24h显像意义不大。Objective To evaluate if hepatobiliary scanning of 6 hours is enough for differentiating biliary atresia （BA） from neonatal hepatitis syndrome （NHS）. Methods 178 consecutive hepatobiliary studies using 99＂Tc iminodiacetic acid were retrospectively analyzed. All of the 6- and 24- hour images were reviewed independently by different physicians. BA was diagnosed when no radioactivity was found in the intestine at 6 or 24 hr after injection of tracer. Results There was 100% agreement for the 6-hr and 24-hr scans among the reviewers. Inter-observer agreement was 89% （159/178）. Conclusion In hepatobiliary imaging using 9~Tc-IDA analogues, 6 hr scan is sufficient. The 24-hr scan does not contribute to the diagnosis of BA.

关 键 词：先天性胆道闭锁 婴儿肝炎综合征 亚胺二醋酸 单光子发射断层扫描计算机 

分 类 号：R725.7[医药卫生—儿科] R816.92[医药卫生—临床医学]