Utility of Tc-99m Mebrofenin Scintigraphy in the Assessment of Infantile Jaundice

• Published in: Clinical nuclear medicine 1995-02, Vol.20 (2), p.153-163
• Main Authors: BEN-HAIM, SIMONA, SEABOLD, JAMES E, KAO, SIMON C. S, JOHNSON, JANN, TRAN, DUG, BROWN, BRUCE P
• Format: Article
• Language: English
• Subjects: Biliary Atresia - complications; Biliary Atresia - diagnostic imaging; Biological and medical sciences; Cholestasis, Intrahepatic - diagnostic imaging; Digestion. Liver. Biliary tract. Spleen. Pancreas; Female; Hepatitis - complications; Hepatitis - diagnostic imaging; Humans; Imino Acids; Infant; Infant, Newborn; Investigative techniques, diagnostic techniques (general aspects); Jaundice, Neonatal - diagnostic imaging; Jaundice, Neonatal - etiology; Liver - diagnostic imaging; Male; Medical sciences; Organotechnetium Compounds; Phenobarbital; Radionuclide Imaging; Radionuclide investigations; Time Factors; Ultrasonography
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/00003072-199502000-00012

Technetium-99m mebrofenin hepatobillary excretory patterns were assessed in 36 infants with hyperbilirubhnemia. Phenobarbital was administered to 22 patients before imaging. Final diagnoses includedintrahepatic chotestasis (14 patients), neonatal hepatitis (nine patients), biliary atresia (eight patients), alpha-1-antitrypsin deficiency (two patients), Ategilleʼs syndrome (two patients), and cystic fibrosis (one patient). No patient with biliary atresia showed bowel activity by 24 hours. Of the 28 infants without biliary atresia, 23 (82%) had bowel activity visualized by 6–8 hours and 26 (90%) had bowel activity by 24 hours. Two had no bowel activity at 24 hoursone had cystic fibrosis and one had neonatal hepatitis. Of the 26 patients with bowel visualization, the time to visualize bowel did not differ between patient groups with and without phenobarbital induction. All of the patients with hepatitis, including those with marked dysfunction, showed good hepatic uptake. Mebrofenin scintigraphy is an important imaging technique in the diagnostic evaluation of infants with hyperbilirubinemia. In addition to biliary atresia, intrahepatic chotestasis due to cystic fibrosis and severe neonatal hepatitis may also cause bowel nonvisualization up to 24 hours. The results of this study suggest phenobarbital induction may not be needed when Tc-99m mebrofenin scintigraphy is used for the assessment of infantile jaundice.