TC-99M-DIETHYL-IDA IMAGING - CLINICAL-EVALUATION IN JAUNDICED PATIENTS

  • 1 January 1980
    • journal article
    • research article
    • Vol. 21  (11) , 1022-1028
Abstract
Hepatobiliary imaging with 99mTc-N,.alpha.-(2,6-diethylacetanilide)-iminodiacetic acid (Tc-diethyl-IDA) was performed in 91 jaundiced patients with documented hepatobiliary damage and serum total bilirubin up to 35 mg/dl. There were 56 patients with obstructive jaundice and 35 with hepatocellular disease. Correct discrimination between hepatocellular and obstructive jaundice was possible with an overall accuracy of 90%. Agreement with the final clinical diagnosis was obtained in 97% of patients with hepatocellular disease, and in 86% of patients with obstructive jaundice. The reliability of the test was inversely related to the serum bilirubin concentration. The incidence of true-positive scans dropped from 93% for bilirubin levels < 10 mg/dl to 83% for bilirubin between 10 and 20 mg/dl. Above 20 mg/dl, the demonstration of a mechanical obstruction was possible in only 1 out of the 4 patients with obstructive jaundice. The high predictive values of the test illustrate that Tc-diethyl-IDA imaging constitutes a reliable method to demonstrate an obstructive cause for the jaundice as long as the bilirubin level remains < 20 mg/dl.