[Hepatobiliary gammagraphy in the diagnosis of Dubin-Johnson syndrome in children].

Using hepatobiliary gammagraphy (99mTc-EHIDA), the authors made 26 examinations in six families with Dubin-Johnson's syndrome. From a series of gammagrams they evaluated the hepatobiliary kinetics and from measurements of the activity of series of blood samples they assessed the half-time of decline of the rapid (Tk1) and slow (Tk2) phase of the curve and the percentage of retention in blood during the 45th minute (R45). The values in a group of normal subjects were 3.4 +/- 0.6 min., 49.1 +/- 8.5 min. and 9.9 +/- 1.7%. In 12 patients with a fully developed clinical picture the liver was visualized intensively and homogeneously within 10 min., in 10 it was enlarged. The intrahepatic biliary pathways were not visualized the passage of activity into the intestinal lumen was delayed above 60 to 120 min., and the increased retention in the liver persisted for more than 120 min. The gallbladder was visualized in six but late and with low intensity. Tk1 was 4.3 to 10.0 min., R45 16.7 to 30.0%. In 9 subjects with the clinically inapparent form the visualization of the intrahepatic pathways was only indicated, the gallbladder was not visualized only in one patient. A protracted retention in the liver was in seven subjects above 60 min., in 2 above 90 min. and in 1 above 120 min. Tk1 was 4.0 to 9.0 min. and R45 12.0 to 27.1%. Hepatobiliary gammagraphy with evaluation of blood clearance of the pharmaceutical preparation is a non-invasive method which helps in the diagnosis of Dubin-Johnson's syndrome.