Hepatic scintigraphy in management of infants and children with liver disease
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Insights
Liver scintiscans in infants with biliary atresia or jaundice showed no distinguishing features. In older children, liver scanning identified defects, aiding diagnosis of hepatoblastoma and other liver disorders.
Area of Science:
- Pediatric Radiology
- Nuclear Medicine
- Hepatology
Background:
- Extrahepatic biliary atresia and severe obstructive jaundice are critical pediatric liver conditions.
- Accurate diagnosis in pediatric liver disease is essential for timely intervention.
- Radionuclide imaging plays a role in evaluating liver function and morphology.
Purpose of the Study:
- To evaluate the utility of liver and spleen scintiscans in differentiating pediatric liver conditions.
- To assess the diagnostic value of technetium 99m sulphur colloid and selenomethionine scintigraphy in pediatric liver disease.
Main Methods:
- Scintiscans of the liver and spleen were performed using technetium 99m sulphur colloid in infants with extrahepatic biliary atresia and obstructive jaundice.
- Liver scintigraphy with technetium 99m sulphur colloid and selenomethionine was conducted in older children with various liver disorders.
Main Results:
- Infants with extrahepatic biliary atresia and obstructive jaundice exhibited similar scintiscan findings, including hepatic size, isotope uptake patterns, and splenic abnormalities, with no distinguishing features.
- In older children, scintiscans were valuable in detecting filling defects in five cases.
- Selenomethionine uptake was observed in hepatoblastoma and haemangioendothelioma filling defects.
- Liver scanning confirmed hepatic abnormalities, indicating the need for further invasive diagnostic procedures.
Conclusions:
- Liver and spleen scintiscans using technetium 99m sulphur colloid lack distinguishing features for differentiating extrahepatic biliary atresia from severe obstructive jaundice in infants.
- Radionuclide imaging, particularly with the use of selenomethionine, can be instrumental in identifying liver filling defects and guiding further investigations for pediatric liver disorders.
Abstract:
Scintiscans of liver and spleen using technetium 99m sulphur colloid in 15 infants with extrahepatic biliary atresia and 11 infants with severe obstructive jaundice (7 with genetic deficiency of alpha 1-antitrypsin) showed similar hepatic size, pattern of isotope uptake, and splenic abnormality with no distinguishing features. In 37 older children with a variety of liver disorders, the scan was invaluable in showing filling defects in five instances. Selenomethionine was taken up not only by the two filling defects due to hepatoblastoma but also in a haemangioendothelioma. In the remaining patiens liver scanning confirmed hepatic abnormality and the necessity for more specific invasive diagnostic investigations.