Cholecystokinin (CCK) functional cholescintigraphy (FC) in patients suspected of acalculous biliary disease (ABD)
To determine if CCK FC can aid in the diagnosis (Dx.) of ABD, the authors retrospectively analyzed the max. gallbladder (GB) ejection fraction response (EFR) to CCK in 240 patients (pts.) with persistent symptoms of biliary colic, a normal GB Ultrasound exam and/or OCG. Each pt. (NPO after 12 A.M.) received 5 mCi of technetium (Tc)-99 Hepatolite. After max GB filling, .02 ..mu..g/kg CCK was administered (1-3 minutes) I.V. Background corrected GB EFs were determined q.5 min x4 by ratioing the pre-CCK GB cts. minus post-CCK GB cts. to pre-CCK GB cts. In 131/240 pts. the max. GBEFR was <35%; 76 had a cholecystectomy (Cx.), 2 an exploratory lap., 53 medical Rx. Of the 76 post-Cx. pts., 74 had chronic cholecystitis (CC) (67 acalculous, 7 calculous), 2 were normal. Exploratory lap. pts, had no GB disease. Clinically 69/70 (4 no followup, 1 no change) post-op CC pts. are improved. One normal GB pt. has persistent pain, the other a Sphincter of Oddi dyskinesia. Of the 53 medical Rx. pts. 23 are lost to followup, and 2 died. Twenty-four are clinically felt to have ABD, 4 are not. In 109/240 pts. the max GBEFR was >35%. Eleven underwent surgery, 98 medical Rx. 4/11 Cx. apts had CAC, 7 were normal. Of the 98 medical Rx. pts. 21 lack followup, 71 are clinically felt not to have ABD; 6 are felt to have ABD. CCK FC appears to be a useful test for the detection of ABD. Its predictive value (GBEF <35%) in Cx. pts. is 97%; in all pts. (assuming medical Rx. correct), 94% (sensitivity - 91%, specificity - 93%).
- Research Organization:
- William Beaumont Hospital, Royal Oak, MI
- OSTI ID:
- 6861962
- Report Number(s):
- CONF-840619-; TRN: 87-018900
- 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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59 BASIC BIOLOGICAL SCIENCES
BILIARY TRACT
DYNAMIC FUNCTION STUDIES
SCINTISCANNING
DIGESTIVE SYSTEM DISEASES
DIAGNOSIS
CALCULI
COMPARATIVE EVALUATIONS
DRUGS
KININS
PAIN
RADIOPHARMACEUTICALS
TECHNETIUM 99
ULTRASONOGRAPHY
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LABELLED COMPOUNDS
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
PEPTIDES
POLYPEPTIDES
PROTEINS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SYMPTOMS
TECHNETIUM ISOTOPES
YEARS LIVING RADIOISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics
550901 - Pathology- Tracer Techniques
551001 - Physiological Systems- Tracer Techniques