Comparison of different diagnostic methods for differentiating biliary atresia from idiopathic neonatal hepatitis
Received 20 September 2008; accepted 8 January 2009. published online 12 March 2009.
Abstract
Aim
To retrospectively analyze different methods in differentiating biliary atresia from idiopathic neonatal hepatitis.
Methods
Sixty-nine infants with cholestatic jaundice and final diagnosis of idiopathic neonatal hepatitis (INH) and biliary atresia (BA) were studied retroprospectively from January 2004 to December 2006. A thorough history and physical examination were undertaken. All cases underwent abdominal magnetic resonance cholangiography (MRCP), ultrasonography (US), hepatobiliary scintigraphy (HBS), HBS single-photon emission computer tomography (HBS SPECT), and operation or percutaneous liver biopsy. The accuracy, sensitivity, specificity, and predictive values of these various methods were compared.
Results
There were 39 girls and 30 boys, among whom 35 had INH (age, 61±17 days) and 34 had BA (age, 64±18 days). The mean age at onset of jaundice was significantly lower in cases of BA when compared to INH cases (9±13 vs. 20±21 days; P=.032). The diagnostic accuracy of different methods was as follows: liver biopsy, 97.1%; HBS SPECT, 91.30%; MRCP, 71.01%; HBS, 66.67%; US, 65.22%.
Conclusion
Our results indicate that biopsy of the liver is considered as the most reliable method to differentiate INH from BA. The accuracy of HBS SPECT is higher than that of MRCP, HBS, and US. There was no significant difference in diagnostic accuracy among MRCP, HBS, and US.
aNuclear Medicine Department of Beijing Friendship Hospital Affiliated to Capital Medical University, 95 Yong An Road Xuanwu District, Beijing 100050, People's Republic of China
bRadiology Department of Beijing Friendship Hospital, Beijing, People's Republic of China
cRadiology Department of Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, People's Republic of China
Corresponding author. Nuclear Medicine Department of Beijing Friendship Hospital Affiliated to Capital Medical University, 95 Yong An Road Xuanwu District, Beijing 100050, People's Republic of China. Tel.: +86 10 63138462.
ABSTRACT