改良法肝胆动态显像对不同程度肝损伤的胆道闭锁患儿的诊断价值OA

Objective:To evaluate the diagnostic value of a modified hepatobiliary scintigraphy approach in infants with biliary atresia(BA),stratified by the severity of liver impairment.Methods:A retrospective analysis of 272 pediatric cases with persistent jaundice was conducted,including 113 cases of BA and 159 cases of intrahepatic cholestasis diagnosed through follow-up or pathology.Patients were categorizd into mild-to-moderate hepatic impairment(n=212)and severe impair-ment(n=60)groups based on ALBI scores.A modified hepatobiliary dynamic imaging analysis method combining visual assessment within 6 hours with semi-quantitative analysis of the intestinal baseline difference was employed.The diagnostic efficacy for BA was compared between conventional hepatobiliary dynamic imaging,the modified method,and ultrasound.Results:For the hepatic dysfunction group,the modified scintigraphy showed significantly better specificity,accuracy,and PPV than conventional scintigraphy(χ2:7.03～12.11,all P＜0.01),and outperformed ultrasound in sensitivity,accuracy,and NPV(χ2:6.90～7.81,all P＜0.01).In cases with severe liver injury,the modified method's specificity,accuracy,and PPV remained significantly higher than those of the conventional method(χ2:7.68～26.01,all P＜0.01).No significant differences were observed between the modified scintigraphy and ultrasound across all metrics(all P＞0.05).Conclusion:Modified hepato-biliary scintigraphy demonstrates high diagnostic value for BA across varying liver injury.