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Cholecystokinin (CCK) functional cholescintigraphy (FC) in patients suspected of acalculous biliary disease (ABD)

Conference · · J. Nucl. Med.; (United States)
OSTI ID:6861962
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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-
Conference Information:
Journal Name: J. Nucl. Med.; (United States) Journal Volume: 25:5
Country of Publication:
United States
Language:
English

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Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
550901 -- Pathology-- Tracer Techniques
551001 -- Physiological Systems-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BILIARY TRACT
CALCULI
COMPARATIVE EVALUATIONS
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM DISEASES
DISEASES
DRUGS
DYNAMIC FUNCTION STUDIES
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
KININS
LABELLED COMPOUNDS
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
PAIN
PEPTIDES
POLYPEPTIDES
PROTEINS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOPHARMACEUTICALS
SCINTISCANNING
SYMPTOMS
TECHNETIUM 99
TECHNETIUM ISOTOPES
ULTRASONOGRAPHY
YEARS LIVING RADIOISOTOPES