Outcome of hepatobiliary scanning: preterm versus full-term cholestatic infants
Objectives The aims of this study were to evaluate the specificity of a non‐draining hepatobiliary scintigraphy (HBS) for biliary atresia (BA) in preterm and full‐term babies, to verify the relationship between non‐draining scan and higher levels of direct bilirubin and to find an objective criterio...
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| Veröffentlicht in: | Journal of paediatrics and child health 2013-01, Vol.49 (1), p.E46-E51 |
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| creator | Siu, Luen Yee Wong, Ka Nin Li, Ka Wah Kwong, Ngai Shan |
| description | Objectives
The aims of this study were to evaluate the specificity of a non‐draining hepatobiliary scintigraphy (HBS) for biliary atresia (BA) in preterm and full‐term babies, to verify the relationship between non‐draining scan and higher levels of direct bilirubin and to find an objective criterion to guide the time in performing HBS.
Methods
A total of 175 infants (113 males and 62 females, median age of 45 days) with 181 HBS performed in Tuen Mun Hospital between January 1998 and May 2010 were retrospectively analysed. A ‘non‐draining’ scan was defined as one showing no excretion of radiolabelled tracer into the small bowel 24 h after injection. The disease category, epidemiological and laboratory data were compared between infants having non‐draining and draining scans. In addition, the predictive value of a negative scan for BA was compared between preterm and full‐term infants.
Results
Twenty infants (11.4%) were surgically confirmed to have BA. A non‐draining scan was found to be 100% sensitive for BA, and the specificity was 96% and 78% among full‐term infants and preterm infants, respectively. The mean direct bilirubin values of infants with BA and intrahepatic cholestasis were 141.9 and 111.3 μmol/L, respectively, which were significantly higher than 67.2 μmol/L seen in infants with draining scans. This analysis shows that using direct bilirubin ≥63 μmol/L as an objective criterion in guiding the time to perform HBS is most cost‐effective.
Conclusion
Our data supported that using direct bilirubin ≥63 μmol/L as an objective criterion in guiding the time to perform HBS will avoid unnecessary scans. |
| doi_str_mv | 10.1111/jpc.12067 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1273583544</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2922844281</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3917-57864e2a219775f8cc33adae6ef44ead5636d78b95696566c5126f1d15c158ef3</originalsourceid><addsrcrecordid>eNp1kE1PFEEQhjtEA4gc-ANmEi94GOia_hxuZKMgblwPKsdOb0-19DJfdM-o_HtbFjiY2JfqVD31pvIQcgT0BPI73YzuBCoq1Q7ZB85pCUrwF_lPGS-5BrpHXqW0oZRWQuhdslexStVQ1_tktZonN3RYDL64wdFOwzq0wcb7Ijnb96H_cVaMESeMXfETY5pT4ee2LR8a7mZoMU12Cq4Ivbf9lF6Tl962CQ8f6wH59uH918VluVxdfFycL0vHalClUFpyrGwFtVLCa-cYs41FiZ5ztI2QTDZKr2shaymkdAIq6aEB4UBo9OyAHG9zxzjczfkI04XksG1tj8OcDFSKCc0E5xl9-w-6GebY5-sMMNCCSiZUpt5tKReHlCJ6M8bQZREGqPlr2WTL5sFyZt88Js7rDptn8klrBk63wK_Q4v3_k8zVl8VTZLndCGnC388bNt6aPFXCXH--MPr7FVx-Wi7NNfsDL4SU4Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1318506357</pqid></control><display><type>article</type><title>Outcome of hepatobiliary scanning: preterm versus full-term cholestatic infants</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Siu, Luen Yee ; Wong, Ka Nin ; Li, Ka Wah ; Kwong, Ngai Shan</creator><creatorcontrib>Siu, Luen Yee ; Wong, Ka Nin ; Li, Ka Wah ; Kwong, Ngai Shan</creatorcontrib><description>Objectives
The aims of this study were to evaluate the specificity of a non‐draining hepatobiliary scintigraphy (HBS) for biliary atresia (BA) in preterm and full‐term babies, to verify the relationship between non‐draining scan and higher levels of direct bilirubin and to find an objective criterion to guide the time in performing HBS.
Methods
A total of 175 infants (113 males and 62 females, median age of 45 days) with 181 HBS performed in Tuen Mun Hospital between January 1998 and May 2010 were retrospectively analysed. A ‘non‐draining’ scan was defined as one showing no excretion of radiolabelled tracer into the small bowel 24 h after injection. The disease category, epidemiological and laboratory data were compared between infants having non‐draining and draining scans. In addition, the predictive value of a negative scan for BA was compared between preterm and full‐term infants.
Results
Twenty infants (11.4%) were surgically confirmed to have BA. A non‐draining scan was found to be 100% sensitive for BA, and the specificity was 96% and 78% among full‐term infants and preterm infants, respectively. The mean direct bilirubin values of infants with BA and intrahepatic cholestasis were 141.9 and 111.3 μmol/L, respectively, which were significantly higher than 67.2 μmol/L seen in infants with draining scans. This analysis shows that using direct bilirubin ≥63 μmol/L as an objective criterion in guiding the time to perform HBS is most cost‐effective.
Conclusion
Our data supported that using direct bilirubin ≥63 μmol/L as an objective criterion in guiding the time to perform HBS will avoid unnecessary scans.</description><identifier>ISSN: 1034-4810</identifier><identifier>EISSN: 1440-1754</identifier><identifier>DOI: 10.1111/jpc.12067</identifier><identifier>PMID: 23279199</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>biliary atresia ; Biliary Atresia - blood ; Biliary Atresia - complications ; Biliary Atresia - diagnostic imaging ; Biliary Atresia - economics ; Bilirubin - blood ; Biomarkers - blood ; cholestasis ; Cost-Benefit Analysis ; Diagnosis, Differential ; Female ; Gestational Age ; Hong Kong ; Humans ; hyperbilirubinaemia ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases - blood ; Infant, Premature, Diseases - diagnostic imaging ; Infant, Premature, Diseases - economics ; Infant, Premature, Diseases - etiology ; Jaundice, Obstructive - blood ; Jaundice, Obstructive - economics ; Jaundice, Obstructive - etiology ; Male ; Outcome Assessment (Health Care) ; premature infant ; Radionuclide Imaging ; Radiopharmaceuticals ; Retrospective Studies ; Sensitivity and Specificity ; Technetium ; Time Factors</subject><ispartof>Journal of paediatrics and child health, 2013-01, Vol.49 (1), p.E46-E51</ispartof><rights>2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians)</rights><rights>2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).</rights><rights>Journal of Paediatrics and Child Health Copyright 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3917-57864e2a219775f8cc33adae6ef44ead5636d78b95696566c5126f1d15c158ef3</citedby><cites>FETCH-LOGICAL-c3917-57864e2a219775f8cc33adae6ef44ead5636d78b95696566c5126f1d15c158ef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjpc.12067$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjpc.12067$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23279199$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Siu, Luen Yee</creatorcontrib><creatorcontrib>Wong, Ka Nin</creatorcontrib><creatorcontrib>Li, Ka Wah</creatorcontrib><creatorcontrib>Kwong, Ngai Shan</creatorcontrib><title>Outcome of hepatobiliary scanning: preterm versus full-term cholestatic infants</title><title>Journal of paediatrics and child health</title><addtitle>J Paediatr Child Health</addtitle><description>Objectives
The aims of this study were to evaluate the specificity of a non‐draining hepatobiliary scintigraphy (HBS) for biliary atresia (BA) in preterm and full‐term babies, to verify the relationship between non‐draining scan and higher levels of direct bilirubin and to find an objective criterion to guide the time in performing HBS.
Methods
A total of 175 infants (113 males and 62 females, median age of 45 days) with 181 HBS performed in Tuen Mun Hospital between January 1998 and May 2010 were retrospectively analysed. A ‘non‐draining’ scan was defined as one showing no excretion of radiolabelled tracer into the small bowel 24 h after injection. The disease category, epidemiological and laboratory data were compared between infants having non‐draining and draining scans. In addition, the predictive value of a negative scan for BA was compared between preterm and full‐term infants.
Results
Twenty infants (11.4%) were surgically confirmed to have BA. A non‐draining scan was found to be 100% sensitive for BA, and the specificity was 96% and 78% among full‐term infants and preterm infants, respectively. The mean direct bilirubin values of infants with BA and intrahepatic cholestasis were 141.9 and 111.3 μmol/L, respectively, which were significantly higher than 67.2 μmol/L seen in infants with draining scans. This analysis shows that using direct bilirubin ≥63 μmol/L as an objective criterion in guiding the time to perform HBS is most cost‐effective.
Conclusion
Our data supported that using direct bilirubin ≥63 μmol/L as an objective criterion in guiding the time to perform HBS will avoid unnecessary scans.</description><subject>biliary atresia</subject><subject>Biliary Atresia - blood</subject><subject>Biliary Atresia - complications</subject><subject>Biliary Atresia - diagnostic imaging</subject><subject>Biliary Atresia - economics</subject><subject>Bilirubin - blood</subject><subject>Biomarkers - blood</subject><subject>cholestasis</subject><subject>Cost-Benefit Analysis</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Hong Kong</subject><subject>Humans</subject><subject>hyperbilirubinaemia</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Premature, Diseases - blood</subject><subject>Infant, Premature, Diseases - diagnostic imaging</subject><subject>Infant, Premature, Diseases - economics</subject><subject>Infant, Premature, Diseases - etiology</subject><subject>Jaundice, Obstructive - blood</subject><subject>Jaundice, Obstructive - economics</subject><subject>Jaundice, Obstructive - etiology</subject><subject>Male</subject><subject>Outcome Assessment (Health Care)</subject><subject>premature infant</subject><subject>Radionuclide Imaging</subject><subject>Radiopharmaceuticals</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Technetium</subject><subject>Time Factors</subject><issn>1034-4810</issn><issn>1440-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1PFEEQhjtEA4gc-ANmEi94GOia_hxuZKMgblwPKsdOb0-19DJfdM-o_HtbFjiY2JfqVD31pvIQcgT0BPI73YzuBCoq1Q7ZB85pCUrwF_lPGS-5BrpHXqW0oZRWQuhdslexStVQ1_tktZonN3RYDL64wdFOwzq0wcb7Ijnb96H_cVaMESeMXfETY5pT4ee2LR8a7mZoMU12Cq4Ivbf9lF6Tl962CQ8f6wH59uH918VluVxdfFycL0vHalClUFpyrGwFtVLCa-cYs41FiZ5ztI2QTDZKr2shaymkdAIq6aEB4UBo9OyAHG9zxzjczfkI04XksG1tj8OcDFSKCc0E5xl9-w-6GebY5-sMMNCCSiZUpt5tKReHlCJ6M8bQZREGqPlr2WTL5sFyZt88Js7rDptn8klrBk63wK_Q4v3_k8zVl8VTZLndCGnC388bNt6aPFXCXH--MPr7FVx-Wi7NNfsDL4SU4Q</recordid><startdate>201301</startdate><enddate>201301</enddate><creator>Siu, Luen Yee</creator><creator>Wong, Ka Nin</creator><creator>Li, Ka Wah</creator><creator>Kwong, Ngai Shan</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201301</creationdate><title>Outcome of hepatobiliary scanning: preterm versus full-term cholestatic infants</title><author>Siu, Luen Yee ; Wong, Ka Nin ; Li, Ka Wah ; Kwong, Ngai Shan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3917-57864e2a219775f8cc33adae6ef44ead5636d78b95696566c5126f1d15c158ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>biliary atresia</topic><topic>Biliary Atresia - blood</topic><topic>Biliary Atresia - complications</topic><topic>Biliary Atresia - diagnostic imaging</topic><topic>Biliary Atresia - economics</topic><topic>Bilirubin - blood</topic><topic>Biomarkers - blood</topic><topic>cholestasis</topic><topic>Cost-Benefit Analysis</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Gestational Age</topic><topic>Hong Kong</topic><topic>Humans</topic><topic>hyperbilirubinaemia</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Premature, Diseases - blood</topic><topic>Infant, Premature, Diseases - diagnostic imaging</topic><topic>Infant, Premature, Diseases - economics</topic><topic>Infant, Premature, Diseases - etiology</topic><topic>Jaundice, Obstructive - blood</topic><topic>Jaundice, Obstructive - economics</topic><topic>Jaundice, Obstructive - etiology</topic><topic>Male</topic><topic>Outcome Assessment (Health Care)</topic><topic>premature infant</topic><topic>Radionuclide Imaging</topic><topic>Radiopharmaceuticals</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Technetium</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Siu, Luen Yee</creatorcontrib><creatorcontrib>Wong, Ka Nin</creatorcontrib><creatorcontrib>Li, Ka Wah</creatorcontrib><creatorcontrib>Kwong, Ngai Shan</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of paediatrics and child health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Siu, Luen Yee</au><au>Wong, Ka Nin</au><au>Li, Ka Wah</au><au>Kwong, Ngai Shan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome of hepatobiliary scanning: preterm versus full-term cholestatic infants</atitle><jtitle>Journal of paediatrics and child health</jtitle><addtitle>J Paediatr Child Health</addtitle><date>2013-01</date><risdate>2013</risdate><volume>49</volume><issue>1</issue><spage>E46</spage><epage>E51</epage><pages>E46-E51</pages><issn>1034-4810</issn><eissn>1440-1754</eissn><abstract>Objectives
The aims of this study were to evaluate the specificity of a non‐draining hepatobiliary scintigraphy (HBS) for biliary atresia (BA) in preterm and full‐term babies, to verify the relationship between non‐draining scan and higher levels of direct bilirubin and to find an objective criterion to guide the time in performing HBS.
Methods
A total of 175 infants (113 males and 62 females, median age of 45 days) with 181 HBS performed in Tuen Mun Hospital between January 1998 and May 2010 were retrospectively analysed. A ‘non‐draining’ scan was defined as one showing no excretion of radiolabelled tracer into the small bowel 24 h after injection. The disease category, epidemiological and laboratory data were compared between infants having non‐draining and draining scans. In addition, the predictive value of a negative scan for BA was compared between preterm and full‐term infants.
Results
Twenty infants (11.4%) were surgically confirmed to have BA. A non‐draining scan was found to be 100% sensitive for BA, and the specificity was 96% and 78% among full‐term infants and preterm infants, respectively. The mean direct bilirubin values of infants with BA and intrahepatic cholestasis were 141.9 and 111.3 μmol/L, respectively, which were significantly higher than 67.2 μmol/L seen in infants with draining scans. This analysis shows that using direct bilirubin ≥63 μmol/L as an objective criterion in guiding the time to perform HBS is most cost‐effective.
Conclusion
Our data supported that using direct bilirubin ≥63 μmol/L as an objective criterion in guiding the time to perform HBS will avoid unnecessary scans.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>23279199</pmid><doi>10.1111/jpc.12067</doi><tpages>6</tpages></addata></record> |
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| subjects | biliary atresia Biliary Atresia - blood Biliary Atresia - complications Biliary Atresia - diagnostic imaging Biliary Atresia - economics Bilirubin - blood Biomarkers - blood cholestasis Cost-Benefit Analysis Diagnosis, Differential Female Gestational Age Hong Kong Humans hyperbilirubinaemia Infant, Newborn Infant, Premature Infant, Premature, Diseases - blood Infant, Premature, Diseases - diagnostic imaging Infant, Premature, Diseases - economics Infant, Premature, Diseases - etiology Jaundice, Obstructive - blood Jaundice, Obstructive - economics Jaundice, Obstructive - etiology Male Outcome Assessment (Health Care) premature infant Radionuclide Imaging Radiopharmaceuticals Retrospective Studies Sensitivity and Specificity Technetium Time Factors |
| title | Outcome of hepatobiliary scanning: preterm versus full-term cholestatic infants |
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