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Titolo:
The use of hepatocyte extraction fraction to evaluate neonatal cholestasis
Autore:
Tolia, V; Kottamasu, SR; Tabassum, D; Simpson, P;
Indirizzi:
Childrens Hosp Michigan, Dept Pediat, Detroit, MI 48201 USA Childrens HospMichigan Detroit MI USA 48201 ediat, Detroit, MI 48201 USA Childrens Hosp Michigan, Dept Radiol, Detroit, MI 48201 USA Childrens HospMichigan Detroit MI USA 48201 adiol, Detroit, MI 48201 USA
Titolo Testata:
CLINICAL NUCLEAR MEDICINE
fascicolo: 9, volume: 24, anno: 1999,
pagine: 655 - 659
SICI:
0363-9762(199909)24:9<655:TUOHEF>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEPATOBILIARY SCINTIGRAPHY; DECONVOLUTIONAL ANALYSIS;
Keywords:
DISIDA scans; hepatocyte extraction fraction; neonatal cholestasis; pediatric hepatobiliary scintigraphy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Tolia, V 3901 Beaubien Blvd, Detroit, MI 48201 USA 3901 Beaubien Blvd Detroit MI USA 48201 d, Detroit, MI 48201 USA
Citazione:
V. Tolia et al., "The use of hepatocyte extraction fraction to evaluate neonatal cholestasis", CLIN NUCL M, 24(9), 1999, pp. 655-659

Abstract

Purpose: Hepatobiliary scintigraphy is used routinely to evaluate infants with neonatal cholestasis. Hepatobiliary scintigraphy determines biliary patency by detecting radioactivity in the bower on imaging, in duodenal and gastric aspirates, or all of these. During hepatobiliary scintigraphy, the hepatocyte extraction fraction (HEF) is calculated by deconvolution analysis. Normal values of HEF are more than 90%. It is believed that HEF may predict hepatic dysfunction, because, during hepatobiliary scintigraphy, the radiopharmaceutical used in this test is extracted by the hepatocytes from theblood stream. Therefore, a low value of HEF is seen with more severe hepatocellular disease. The goal of this study was to determine whether HEF has any correlation with synthetic liver function, whether HEF can differentiate obstructive from nonobstructive lesions that cause neonatal cholestasis, and whether HEF can predict the outcome of the different causes of neonatalcholestasis. Methods: A retrospective analysis of 68 hepatobiliary scintigraphy resultswas done in patients with neonatal cholestasis for a period covering 6 years. Results: The HEF was available in 67 of these 68 patients, with a median value of 25% (range, 3.3% to 100%). The results of synthetic liver function tests (i.e., albumin and prothrombin time) were normal in all infants with neonatal cholestasis. No significant correlation was detected between HEF and the serum levels of total and direct bilirubin, albumin, alkaline phosphatase, and prothrombin time by exploratory data analysis (R = 0.08; small, P > 0.2). The HEF values in different causes of neonatal cholestasis were compared: extrahepatic biliary atresia, neonatal hepatitis, and a miscellaneous category consisting of alpha(1)-antitrypsin deficiency, ischemic hepatitis, paucity of bile ducts, and others. The outcomes of these diseases wereassessed as resolution, continuing disease, transplantation, or death, butno predictive correlation was found with HEF. Conclusions: A single determination of HEF is of no value in assessing synthetic liver function (as assessed by albumin and prothrombin time), specific diagnoses, and outcomes in patients with neonatal cholestasis. Therefore, a low isolated value of HEF should not be considered suggestive of poor prognosis and outcome in these patients.

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Documento generato il 19/09/20 alle ore 22:57:48