{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T05:46:18Z","timestamp":1771047978542,"version":"3.50.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Biliary Atresia (BA) requires prompt diagnosis and surgical intervention to optimize its outcome. The aim of this study was to evaluate the accuracy of EHIDA in distinguishing between BA and other causes of cholestatic jaundice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective study of all patients who underwent EHIDA in a tertiary center from 1997 to 2019. The sensitivity, specificity, Negative Predictive Value (NPV) and Positive Predictive Value (PPV) of EHIDA were evaluated. Factors that can potentially affect its accuracy were also analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 93 patients aged 10 to 110 days with cholestasis and suspected BA underwent EHIDA. The sensitivity and NPV were 91.2 and 85.3% while specificity and PPV were 80.6 and 88.1%. These results suggested that EHIDA is suboptimal in both diagnosing or excluding BA. Out of 59 patients who showed no tracer activities in the intestines after 24 h, 56 were subjected to surgical exploration and 52 (92.9%) were eventually diagnosed BA. The accuracy of EHIDA scan were different by the maturity of the patient, age at testing and severity of cholestasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EHIDA has a limited accuracy and surgical exploration remains the gold standard to establish the diagnosis of BA. Potential confounding factors that may affect the accuracy of EHIDA were identified but require further studies with larger sample sizes to validate.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.874809","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T06:17:20Z","timestamp":1653977840000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["The Value of Hepatic Scintigraphy in the Diagnosis of Biliary Atresia"],"prefix":"10.3389","volume":"10","author":[{"given":"Wing Ki","family":"Chan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick Ho Yu","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth Kak Yuen","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1704","DOI":"10.1016\/S0140-6736(09)60946-6","article-title":"Biliary atresia","volume":"374","author":"Hartley","year":"2009","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.cgh.2011.01.003","article-title":"Design and validation of the biliary atresia research consortium histologic assessment system for cholestasis in infancy","volume":"9","author":"Russo","year":"2011","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1097\/MPG.0000000000001334","article-title":"Guideline for the evaluation of cholestatic jaundice in infants: joint recommendations of the north american society for pediatric gastroenterology, hepatology, and nutrition and the european society for pediatric gastroenterology, hepatology, and nutrition","volume":"64","author":"Fawaz","year":"2017","journal-title":"J Pediatr Gastroenterol Nutr."},{"key":"B4","volume-title":"Hepatobiliary Iminodiacetic Acid Scan","author":"Snyder","year":"2021"},{"key":"B5","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1007\/s12098-017-2408-z","article-title":"Role of hepatobiliary scintigraphy and preoperative liver biopsy for exclusion of biliary atresia in neonatal cholestasis syndrome","volume":"84","author":"Mandelia","year":"2017","journal-title":"Indian J Pediatr."},{"key":"B6","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1007\/s13139-019-00606-w","article-title":"False-negative hepatobiliary scintigraphy for biliary atresia","volume":"53","author":"Kim","year":"2019","journal-title":"Nucl Med Mol Imaging."},{"key":"B7","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1053\/j.semperi.2004.09.008","article-title":"Neonatal cholestasis","volume":"28","author":"Venigalla","year":"2004","journal-title":"Semin Perinatol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/s12519-015-0071-x","article-title":"Comparison of different noninvasive diagnostic methods for biliary atresia: a meta-analysis","volume":"12","author":"He","year":"2016","journal-title":"World J Pediatr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"132089","DOI":"10.5402\/2012\/132089","article-title":"Biliary atresia: 50 years after the first kasai","volume":"2012","author":"Wildhaber","year":"2012","journal-title":"ISRN Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1002\/bjs.8929","article-title":"Systematic review and meta-analysis of randomized clinical trials of self-expanding metallic stents as a bridge to surgery versus emergency surgery for malignant left-sided large bowel obstruction (Br J Surg 2012; 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