Hepatobiliay scintigraphy studies in iraq

Introduction: Hepatobiliary (HB) scintigraphy is a radionuclide scintigraphic method frequently used in evaluation of various liver and biliary tracts disorders. Objective: To evaluate the usefulness of this method in diagnosis of various HB disorder; to clarify the scintigraphic patterns of each disorder, to establish the final diagnosis using this technique; to find out the sensitivity, specificity and accuracy of this technique. Patients and Method: 71 cases with different HB diseases who had a conventional radionuclide HB imaging in Teaching hospital nuclear medicine unit in Baghdad were reviewed retrospectively. Results: 33 patients were females, 38 patients were males. Their ages ranged between (1 month - 70 yr). The study showed that only two peaks of age groups:(1 month,- 6 month) (39.4 %) and 41 - 65 yr. (38%). The final scintigraphic diagnosis demonstrated that 27 cases (38 %) had biliary atresia: 7 cases (9.85 %) had acute cholecystitis; 3 cases (4.2 % had chronic cholecystitis; 8 cases (11.26%) had partial biliary obstruction: 7 cases (9.85) had complete biliary obstruction and 6 cases (8.45 %) had parenchymal liver disease. While the rest of our series showed normal scintigraphic studies (18.3%). Conclusion: Biliary atresia was the most common disease found in our series. This, statistically, doesn't reflect the prevalence of all HB disorders because of the limited number of patients. The overall sensitivity and specificity and accuracy for various HD disorders can be calculated. Thus, this study revealed that this technique had statistically high sensitivity 95%; excellent specificity 100 % and very high accuracy 97 %. Therefore we recommend the clinical application of HB scintigraphic technique in assessment of patients with suspected liver and biliary system disorders and we emphasize that HB scintigraphy is mandatory in urgent cases such as biliary atresia and acute cholecystitis.