Differential diagnosis between neonatal hepatitis and biliary atresia using 99mTc DISIDA scintigraphy.

ABSTRACT

99mTc DISIDA Scintigrams of intants being investigated for proliged jaundice grom May 1983. to December 1987 were studied in order to determine the accuracy and usefulness of the test in differentiating extrahepatic biliary atresia (EHBA) from neonatal hepatitis. The patients were divided into 2 groups, group A consisting of those done from May 1983 to December 1986 and Group B consisting of those done from January to December 1987. The sensitivity, specificity, accuracy, positive and negative perdictive value of the test in each group were 62, 57, 58, 35, and 90, 77, 83, 75, 91%, respectively. With more experience and improved technique, today 99mTc-DISIDA scintigraphy has become an accurate test foe differentiating EHBA from neonatal hepatitis. When radiotracer is demonstrated in the intestine, EHBA can virtually be excluded. When no bowcl excretion is seen upto 24 hours, EHBA is probable and further invasive procedures are justified.