Evaluation of the postoperative patient with /sup 99m/Tc-IDA cholescintigraphy
In order to assess the role of /sup 99m/Tc-iminodiacetic acid (IDA) cholescintigraphy in evaluating postoperative patients, a total of 213 studies were performed in 189 patients over a 3-year time period. Of these, 130 studies were obtained in 125 cases with signs and/or symptoms suggesting postcholecystectomy syndrome. A normal sized duct that emptied within an hour ruled out significant pathology with a high degree of accuracy (97%). A less reliable finding of normalcy was the combination of ductal dilatation with functional patency in that three of 20 patients (15%) who exhibited this pattern were proven to have nonobstructing calculi in their common bile duct. AZ spectrum of abnormal findings was encountered. Ductal dilatation was a most significant indicator of partial or intermittent ductal obstruction when it was associated with altered time-activity dynamics in the ducts and secondarily, delayed biliary-to-bowel transit time of the radiotracer. Patterns indicating complete common duct obstruction, cystic duct remnants, and bile leaks also proved to be very sensitive. Seventy-three studies in 56 patients very accurately evaluated the integrity of biliary-enteric bypass anastomosis. Complete and partial obstructive patterns were similar in appearance to those encountered in postcholecystectomy syndrome. Several leaks were also detected in this patient population. Ten studies were performed in eight patients who underwent Billroth II gastroenterostomies primarily to see if afferent loop obstruction was present. Three of these patients did demonstrate dilated A-loops with stasis, thereby making a positive diagnosis possible.
- Research Organization:
- Department of Nuclear Medicine, Montefiore Hospital and Medical Center, Bronx, NY
- OSTI ID:
- 6879624
- Journal Information:
- Semin. Nucl. Med.; (United States), Vol. 12:1
- Country of Publication:
- United States
- Language:
- English
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59 BASIC BIOLOGICAL SCIENCES
BILIARY TRACT
SCINTISCANNING
DIGESTIVE SYSTEM DISEASES
DIAGNOSIS
TECHNETIUM 99
DIAGNOSTIC USES
ACETIC ACID ESTERS
ISOMERIC NUCLEI
PATHOLOGY
PATIENTS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
CARBOXYLIC ACID ESTERS
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
ESTERS
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
RADIOISOTOPE SCANNING
RADIOISOTOPES
TECHNETIUM ISOTOPES
USES
YEARS LIVING RADIOISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics
550901 - Pathology- Tracer Techniques