99Tcm-EHIDA SPECT combined with planar hepatobiliary scintigraphy for the differentiation between infant biliary atresia and neonatal hepatitis

Objective To evaluate the value of 99Tcm-EHIDA SPECT combined with planar hepatobiliary scintigraphy (combined scintigraphy) in the differentiation of infant biliary atresia (BA) from neonatal hepatitis (NH). Methods This is a retrospective study on 32 infants with cholestasis (18 males, 14 females; age: 28-83 d) from June 2013 to June 2014. All infants underwent sequential 99Tcm-EHIDA hepatobiliary planar scintigraphy and combined scintigraphy, and the diagnostic efficacy of the 2 methods for differentiating infant BA from NH was analyzed by χ2 test. Results In sequential planar scintigraphy, the diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 76.2%(16/21), 6/11, 68.8%(22/32), 76.2%(16/21) and 6/11, respectively. In combined scintigraphy, the diagnostic parameters were 95.2%(20/21), 8/11, 87.5%(28/32), 87.0%(20/23) and 8/9, respectively. Combined scintigraphy correctly identified 4 BA cases that were misdiagnosed as NH by planar scintigraphy. The sensitivity of combined scintigraphy was significantly higher than that of planar scintigraphy (χ2=4.285, P 0.05). Conclusions Combined scintigraphy has incremental value for the differentiation of infant BA from NH. Key words: Biliary atresia; Hepatitis; Infant; Infant, newborn; Radionuclide imaging; Tomography, emission-computed, single-photon; EHIDA