The role of scintiangiography in suspected acute cholecystitis: The hyperemic gallbladder fossa
Gallbladder hyperemia in acute cholecystitis (AC) has been described pathologically and angiographically. The authors' purpose is to evaluate the use of scintiangiography for the detection of this hypernia as a supporting sign of AC. Ten mCi of Tc 99m disofenin were injected by bolus technique in 64 patients with suspected AC. Sequential 3 second images were obtained with a 500K blood pool image at one minute. Routine images to 60 minutes were performed followed by delayed views. The scintiangiogram was positive if there was focal increased activity in the gallbladder fossa greater than liver and separate from right kidney during the preportal arterial phase. The location of the gallbladder fossa was determined by superimposition with the early hepatocyte phase. AC was confirmed surgically and normals confirmed clinically. Increased flow to the gallbladder fossa was demonstrated in 23/32 cases of AC and in 2/33 normals (72% sensitivity, 94% specificity). Accuracy is 54/65 (83%). Positive predictive value is 23/25 (92%). All patients with both a positive scintiangiogram and cholescintigram had AC, while 3 with pericholecystic abscess and false negative cholescintigram had positive scintiangiograms. Increased perfusion to the gallbladder fossa during scintiangiography is a sign of AC. This along with gallbladder nonvisualization by cholescintigraphy was able to predict AC in 100% of cases where both findings occurred. Scintiangiography may help select our patients with a very high likelihood of AC and may potentially shorten chole-scintigraphy examinations.
- Research Organization:
- Univ. of Southern California School of Medicine, Los Angeles, CA
- OSTI ID:
- 6781240
- Report Number(s):
- CONF-840619-; TRN: 87-008826
- Journal Information:
- J. Nucl. Med.; (United States), Vol. 25:5; Conference: 31. annual meeting of the Society of Nuclear Medicine, Los Angeles, CA, USA, 5 Jun 1984
- Country of Publication:
- United States
- Language:
- English
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