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ORIGINAL ARTICLES  PEDIATRICS II 

The Quarterly Journal of Nuclear Medicine 1998 June;42(2):113-8

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Hepatobiliary scintigraphy in current pediatric practice

Roca I., Ciofetta G.*

From the Division of Nuclear Medicine HGU Vall d’Hebron, Barcelona, Spain and the *Laboratory of Pediatric Nuclear Medicine, Pediatric Clinic, “La Sapienza” University, Rome, Italy


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Hepatobiliary scin­tig­ra­phy is the ­only non-inva­sive tech­nique pro­vid­ing ­real-­time assess­ment of hep­a­toc­y­tes func­tion and ­bile pro­gres­sion ­from the liv­er to the intes­tine; for ­this rea­son it is of ­great impor­tance in the ­study of jaun­dice and ­many oth­er dis­or­ders of the liv­er and the bil­iary ­tract in chil­dren. Ultrasonography is the ­initial meth­od of eval­u­at­ing the ­intra- and ­extrahepat­ic ­bile ­ducts dil­a­ta­tion; the dif­fe­ren­tial diag­no­sis ­between bil­iary atre­sia and neo­na­tal hep­a­titis can­not how­ev­er be ­done with­out hepat­o­bil­iary scin­tig­ra­phy. Cystic fibro­sis ­patients ­also ­require hepa­tobil­iary scin­tig­ra­phy; liv­er and bil­iary ­tract dis­ease can real­ly ­occur inde­pen­dent­ly of the under­ly­ing dis­ease sever­ity and the pres­ence of stea­tor­rhea. Hepatobiliary imag­ing in chil­dren who ­have under­gone liv­er trans­plan­ta­tion is of ­major impor­tance; it can ­assess vas­cu­lar­ity, paren­chy­mal func­tion, bil­iary drain­age, pos­sible pres­ence of a ­bile ­leak and obstruc­tion; it has ­very ­good sen­si­tiv­ity and spec­i­fic­ity for the detec­tion of bil­iary ­leak and bil­iary stric­ture. Due to ­these impor­tant clin­i­cal con­di­tions ­being stud­ied in pedi­at­rics, ­both qual­ita­tive and quan­ti­ta­tive infor­ma­tions (func­tion­al indi­ces ­obtained ­from radio­ac­tiv­ity/ ­time ­curve anal­y­sis) ­need to be extract­ed; in addi­tion, ­SPECT acqui­si­tion ­allows ­more accu­rate eval­u­a­tion of abdom­i­nal activ­ity dur­ing the excre­to­ry ­phase.

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