Primary sclerosing cholangitis: correlation of hepatobiliary scintigraphy with clinical and laboratory status

The aim of this study was to determine whether hepatobiliary scintigraphy using (99m)technetium based di-isopropryl-imino-diacetic acid correlated to clinical or laboratory status of patients with primary sclerosing cholangitis (PSC). We carried out a retrospective case-control study involving 15 patients with proven PSC. Fifty-seven hepatobiliary scintigraphic studies were reviewed by consensus of two experienced observers using a semiquantitative scheme to score liver size and degree of radiopharmaceutical uptake, intrahepatic or extrahepatic biliary stasis, segmental liver clearance half-times and gall bladder visualization. The results were compared with age; disease duration; weight loss; serum bilirubin, alkaline phosphatase and albumin levels; antipyrine clearance; number of biliary stents and episodes of cholangitis and history of transplantation. Sixteen age-matched and sex-matched individuals with PSC, who did not undergo hepatobiliary scans, were selected for comparison. Among the scintigraphic variables, right lateral and superior liver clearance half-time values showed a significant linear correlation with disease duration and serum alkaline phosphatase levels (P < 0.05) but not with other clinical or biochemical indices. Other scintigraphic variables showed no correlation. An abnormal, hepatobiliary scan liver clearance half-time in patients with PSC correlates to disease duration and increased serum alkaline phosphatase levels, and this variable may be used to identify some subjects with more advanced disease.