^99Tc^m-MIBI诊断重度淤胆型婴儿肝炎综合征的价值  

^99Tc^m-MIBI hepatobiliary scintigraphy in peadiatric patients with severe cholestatic infant hepatitis syndrome

作　　者：陈贵兵[1] 黄劲雄[1] 何小江[1] 罗作明[1] 卢正远[2] 吴华[1] 

机构地区：[1]厦门大学附属第一医院核医学科,361000 [2]厦门大学附属第一医院新生儿科,361000

出　　处：《国际放射医学核医学杂志》2010年第3期168-170,共3页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的鉴于^99Tc^m-二乙基亚氨基二乙酸（^99Tc^m-EHIDA）肝胆显像对临床重度淤胆患儿应用的局限性，试用^99Tc^m-甲氧基异丁基异腈（^99Tc^m-MIBI）作为新的肝胆显像剂，了解其应用基础及对重度淤胆患儿的初步诊断价值。方法建立胆总管闭锁动物模型，了解^99Tc^m-MIBI肝胆显像的应用基础；对重度淤胆并最终临床证实为婴儿肝炎综合征的27例患儿先行常规^99Tc^m-EHIDA肝胆显像，次日行24h延迟显像，1h后再行印^99Tc^m-MIBI肝胆显像。比较两种显像剂对重度淤胆型婴儿肝炎综合征的诊断价值。结果动物实验证明，^99Tc^m-MIBI确经肝胆排泄，且无明显肠道自分泌现象，可以用作肝胆显像。初步临床诊断表明，^99Tc^m-MIBI肝胆显像对重度淤胆型婴儿肝炎综合征的诊断灵敏度达100％，远远高于常规^99Tc^m-EHIDA肝胆显像（66．67％）.结论对临床高度怀疑的重度淤胆型婴儿肝炎综合征，^99Tc^m-MIBI肝胆显像的诊断灵敏度明显高于常规^99Tc^m-EHIDA肝胆显像。Objective Because of the limited of ^99Tc^m-diethyl iminodiacetic acid （^99Tc^m-EHIDA） hepatobiliary scintigraphy in the diagnosis of severe cholestatic infant hepatitis syndrome, trial use ^99Tc^m- methoxy isobutyl isonitrile （^99Tc^m-MIBI） as a new hepatobiliary scintigraphy imaging agent to understand its applied basis and primary evaluate value in diagnosis of severe cholestatic infant hepatitis syndrome. Methods Constructed choledochal atresia animal model and investigated the application basis of ^99Tc^m-MIBI hepatobiliary scintigraphy. Twenty-seven children patients of severe cholestatic who finally confirmed infant hepatitis syndrome were underwent firstly ^99Tc^m-EHIDA hepatobiliary scintigraphy. After 24 h delay imaging next day,^ 99Tc^m-MIBI hepatobiliary scintigqaphy was underwent after 1 h. Two imaging agents of value in the diagnosis of severe cholestatic infant hepatitis syndrome were compared. Results It was proved that ^99Tc^m- MIBI was surely exereted by hepatobiliary and had no intestinal autocrine phenomenon in animal test. So 99Tc^m-MIBI can be used to undergo hepatobiliary scintigTaphy. The sensitivity of ^99Tc^m-MIBI hepatobiliary scintigraphy in the diagnosis of severe cholestatic infant hepatitis syndrome was 100% in our primary clinical study. Its sensitivity was higher than which of ^99Tc^m-EHIDA hepatobiliary scintigraphy（66.67%） by far. Conclusions With regard to those children patients who suspected highly severe cholestatic infant hepatitis syndrome in clinical, the sensitivity of ^99Tc^m-MIBI hepatobiliary scintigraphy is obviously superior to conventional ^99Tc^m-EHIDA hepatobiliary scintigraphy.

关 键 词：胆汁淤积 肝炎 婴儿 99M锝甲氧基异丁基异腈 99m锝二乙基-亚氨基二乙酸 

分 类 号：R725.7[医药卫生—儿科]