COMPARISON TECHNETIUM OF TC-99M DISOFENIN CHOLESCINTIGRAPHY WITH ULTRASONOGRAPHY IN THE DIFFERENTIATION OF BILIARY ATRESIA FROM OTHER FORMSOF NEONATAL JAUNDICE

Technetium Tc-99m disofenin cholescintigraphy (CS) and ultrasonography (US) are two major clinical methods used in differentiating biliary a tresia (BA) from neonatal jaundice. To compare the diagnostic utility of these two modalities, 66 patients with neonatal cholestasis (15 BA, 3 choledochal cyst (CC), 32 neonatal hepatitis, 13 prolonged jaundice , 2 total parenteral nutrition, and 1 sepsis) underwent Tc-99m disofen in CS and US. The diagnostic sensitivity, specificity, and accuracy of CS in differentiating BA from other forms of neonatal jaundice was 10 0%, 87.5%, and 90.5%, respectively, and for US 86.7%, 77.1%, and 79.3% , respectively. Tc-99m disofenin CS after premedication with phenobarb ital and cholestyramine is a convenient and reliable method of differe ntiating BA from neonatal hepatitis, with a diagnostic accuracy superi or to that of US. However, US is the initial imaging procedure of choi ce in patients presenting with jaundice to rule out anatomic anomalies such as CC.