比较99mTc-EHIDA SPECT/CT肝胆动态显像各时相诊断价值

目的 比较^99mTc-EHIDA肝胆动态显像不同时相诊断肝胆疾病的价值。方法 回顾性分析经病理学或临床综合确诊的387例接受^99mTc-EHIDA肝胆动态显像的肝胆疾病患者，根据肠道显像情况将其分为排泄正常组（n=65，均为非肝胆系疾病或肝胆系疾病痊愈者）和排泄异常组。观察排泄正常组早期相和延迟相代表排泄通畅的影像学表现是否一致；计算排泄异常组延迟各时相对疾病的检出率。结果 排泄正常组中，62例早期相与延迟相的影像学表现一致，3例延迟相可确认排泄通畅。排泄异常组中，延迟相2 h与4 h、4 h与6 h对婴儿先天性BA、IHS及胆总管囊肿检出率差异均有统计学意义（P均<0.008），延迟相6 h与24 h对婴儿先天性BA、IHS及胆总管囊肿检出率差异均无统计学意义（P均>0.008）；延迟各时相对胆汁漏的检出率均较高，2 h与4 h、4 h与6 h、6 h与24 h比较差异均无统计学意义（P均>0.008）。结论 ^99mTc-EHIDA肝胆动态显像对多种肝胆系疾病具有较好的诊断价值。

Comparison of diagnostic value of 99mTc-EHIDA SPECT/CT hepatobiliary dynamic imaging at different phases

Objective To explore the value of ^99mTc-EHIDA hepatobiliary dynamic imaging at different phases for diagnosis of hepatobiliary diseases. Methods Totally 387 patients with hepatobiliary diseases confirmed by pathology or clinical data were retrospectively analyzed. All patients underwent ^99mTc-EHIDA hepatobiliary dynamic imaging. According to intestinal imaging, the patients were divided into normal excretory group (n=65, without hepatobiliary disease or cured) and abnormal excretory group (n=322, including 127 cases of biliary atresia, 108 cases of infant hepatitis syndrome, 62 cases of choledochal cyst and 25 cases of bile leakage). In normal excretory group, the consistency of imaging findings of excretory patency between the early phases and the delayed phases was observed. In abnormal excretory group, the detection rates of hepatobiliary diseases at different phases were calculated and compared. Results In normal excretory group, imaging findings of excretory patency between the early phases and the delayed phases were consistent in 62 cases, and normal excretion was confirmed at the delayed phase in 3 cases. In the abnormal excretory group, differences of detection rates of BA, IHS and choledochal cyst were all statistically significance between 2 h and 4 h as well as between 4 h and 6 h (all P <0.008), but not between 6 h and 24 h (all P>0.008). The detection rates of bile leakage were higher in delay phases, and there was no statistical significance between 2 h and 4 h, 4 h and 6 h nor 6 h and 24 h (all P>0.008). Conclusion ^99mTc-EHIDA hepatobiliary dynamic imaging has good diagnostic value for various diseases of hepatobiliary system.