Document Detail

Evaluation of mebrofenin hepatoscintigraphy in neonatal-onset jaundice.
MedLine Citation:
PMID:  9880637     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The prognosis of infants with prolonged neonatal jaundice is dependent on early diagnosis because of the need for prompt surgical management of biliary atresia. OBJECTIVE: To evaluate the usefulness of 99 mTcm-trimethylbromo-iminodiacetic acid (TBIDA, mebrofenin) in the investigation of infantile jaundice. MATERIALS AND METHODS: A retrospective study was undertaken of 58 patients with unexplained prolonged neonatal jaundice. Sixty-eight scans were reviewed. RESULTS: Mebrofenin scintigraphy confirmed the presence of a choledochal cyst in three of the four cases with that diagnosis. There were no false negative results in the nine patients with extrahepatic biliary atresia (EHBA). Three further infants had an incorrect histological diagnosis of EHBA. A gall bladder was identified by US in each case and in one of these, scintigraphy showed gut excretion. In the 16 patients with no gut excretion by 24 h, the final diagnoses were intrahepatic cholestasis (n = 7), Alagille's syndrome (n = 3), neonatal hepatitis (n = 3), alpha-1-antitrypsin deficiency (n = 2) and juvenile xanthogranuloma (n = 1). Seven infants had repeat scintigraphy after the administration of ursodeoxycholic acid (URSO). This changed five non-excretors with hepatitis into excretors. Two infants with hepatitis continued to show non-excretion after URSO, but a gallbladder was identified by US in both. CONCLUSIONS: Mebrofenin scintigraphy is accurate in confirming the presence of a choledochal cyst and in refuting the diagnosis of EHBA. While histology and scintigraphy are each 100 % sensitive for the diagnosis of EHBA, neither, individually, is accurate and the investigation of prolonged neonatal jaundice requires a multi-modality imaging strategy.
K Johnson; H M Alton; S Chapman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric radiology     Volume:  28     ISSN:  0301-0449     ISO Abbreviation:  Pediatr Radiol     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-01-28     Completed Date:  1999-01-28     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0365332     Medline TA:  Pediatr Radiol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  937-41     Citation Subset:  IM    
Radiology Department, Birmingham Children's Hospital NHS Trust, Steelhouse Lane, Birmingham B4 6NH, UK.
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MeSH Terms
Biliary Atresia / complications,  radionuclide imaging
Choledochal Cyst / complications,  radionuclide imaging
Hepatitis / complications,  congenital,  radionuclide imaging
Imino Acids / diagnostic use*
Infant, Newborn
Jaundice, Neonatal / etiology,  radionuclide imaging*
Liver / radionuclide imaging*
Organotechnetium Compounds / diagnostic use*
Radiopharmaceuticals / diagnostic use*
Retrospective Studies
Reg. No./Substance:
0/Imino Acids; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/technetium Tc 99m mebrofenin

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