Preliminary results obtained with Tc-99m-labelled N-2.6 (dimethyl phenylcarbamoilmethyl) iminodiacetic acid (5-HIDA) in the study of liver and bile function in the newborn are presented. HIDA has a molecular weight of 367. It is easily tagged with Tc-99m, with which it probably forms a dimer, and is rapidly excreted via the bile (and to a lesser extent through the kidneys), without undergoing conjugation during its passage through the liver cells. One mCi of the Tc-99m-HIDA complex was given i.v. to 20 patients aged 4 days to 3 months with persistent icterus (blood bilirubin between 2.5 and 19.6 mg%) and suspected biliary duct obstruction. A Pho-Gamma V scintillation camera was used to take serial scintiphotos from the time of injection for 24 hr. The liver appeared within the first few minutes, in cases where bilirubin was mainly direct (conjugated) and there was no obstruction. Activity was noted in the gall-bladder and/or small intestine after 10-20 min. Renal activity appeared in the first few minutes, but was no longer seen after 30 min. In patients with inspissated bile and partial obstruction, activity was seen in the liver and bile ducts after 15 min and in the small intestine after 60 min. High activity in the bladder after 2 hrs indicated that the tracer was being continuusly eliminated by the kidneys rather than by excretion through the bile ducts. In cases of total bile duct atresia, neither the liver parenchyma nor the gall-bladder could be seen even after 8 hrs. Moreover, the tracer did not appear in the small intestine. Intestinal activity was noted when the bile system was patent in all subjects with variously enhanced blood bilirubin levels, but never in those with complete duct obstruction. It is concluded that Tc-99m-HIDA is of great help in the functional study of bile duct patency in newborns with direct-bilirubin jaundice.
Tc-99(m)-HIDA in the diagnosis of hepatobiliary diseases in children [PRIMI RISULTATI NELLA DIAGNOSI DELLE MALATTIE EPATOBILIARI CON IL COMPLESSO Tc-99m-HIDA IN PEDIATRIA]
BONA, Gianni;SILVESTRO, Leandra
1979-01-01
Abstract
Preliminary results obtained with Tc-99m-labelled N-2.6 (dimethyl phenylcarbamoilmethyl) iminodiacetic acid (5-HIDA) in the study of liver and bile function in the newborn are presented. HIDA has a molecular weight of 367. It is easily tagged with Tc-99m, with which it probably forms a dimer, and is rapidly excreted via the bile (and to a lesser extent through the kidneys), without undergoing conjugation during its passage through the liver cells. One mCi of the Tc-99m-HIDA complex was given i.v. to 20 patients aged 4 days to 3 months with persistent icterus (blood bilirubin between 2.5 and 19.6 mg%) and suspected biliary duct obstruction. A Pho-Gamma V scintillation camera was used to take serial scintiphotos from the time of injection for 24 hr. The liver appeared within the first few minutes, in cases where bilirubin was mainly direct (conjugated) and there was no obstruction. Activity was noted in the gall-bladder and/or small intestine after 10-20 min. Renal activity appeared in the first few minutes, but was no longer seen after 30 min. In patients with inspissated bile and partial obstruction, activity was seen in the liver and bile ducts after 15 min and in the small intestine after 60 min. High activity in the bladder after 2 hrs indicated that the tracer was being continuusly eliminated by the kidneys rather than by excretion through the bile ducts. In cases of total bile duct atresia, neither the liver parenchyma nor the gall-bladder could be seen even after 8 hrs. Moreover, the tracer did not appear in the small intestine. Intestinal activity was noted when the bile system was patent in all subjects with variously enhanced blood bilirubin levels, but never in those with complete duct obstruction. It is concluded that Tc-99m-HIDA is of great help in the functional study of bile duct patency in newborns with direct-bilirubin jaundice.
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