technetium-tc-99m-lidofenin and Cholelithiasis

Topics: Adult; Bile Ducts; Cholecystitis; Cholelithiasis; Cholestasis, Extrahepatic; Cholestasis, Intrahepatic; Common Bile Duct Diseases; Cysts; Hepatitis; Humans; Imino Acids; Infant, Newborn; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Tomography, X-Ray Computed; Ultrasonography

Topics: Acute Disease; Cholecystitis; Cholelithiasis; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Acute cholecystitis is a relatively common clinical entity characterized histopathologically by obstruction of the cystic duct due to either edema or stone or both. Thorough clinical assessment and selection of the appropriate diagnostic tests are crucial in making an early diagnosis before surgical treatment. Many diagnostic tests are available for imaging the gallbladder. Hepatobiliary imaging using technetium Tc 99m IDA is the test of choice to either exclude or confirm the diagnosis of acute cholecystitis and it carries a discriminating power greater than that of cholecystography or ultrasonography. In most patients the exclusion of the diagnosis of acute cholecystitis can be made as early as 30 minutes and the confirmation within three hours. The confirmation of acute cholecystitis by radionuclide imaging obviates the need for either cholecystography or ultrasonography.

Topics: Acute Disease; Cholecystectomy; Cholecystitis; Cholecystography; Cholelithiasis; Costs and Cost Analysis; Diagnosis, Differential; Evaluation Studies as Topic; Gallbladder; Humans; Imino Acids; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Biliary microlithiasis is an uncommon but recognized cause of upper abdominal pain, cholecystitis, cholangitis, and pancreatitis in adults. Gallstones smaller than 3 mm may not be seen on transabdominal ultrasound and may only be seen on endoscopic ultrasound. This condition is poorly described in children. The aim of this study is to review the results of laparoscopic cholecystectomy to treat biliary microlithiasis in a pediatric case series.. We performed a retrospective case review of children with biliary microlithiasis who were treated with laparoscopic cholecystectomy.. Three children were diagnosed with biliary microlithiasis. Two patients had recurrent right upper quadrant pain and nausea. A third patient had midepigastric pain and idiopathic pancreatitis. All 3 had a normal gallbladder on transabdominal ultrasound. Additional imaging with hepatobiliary scan, computed tomography, and magnetic resonance cholangiopancreatography revealed no biliary source for symptoms. Endoscopic ultrasound was performed on all 3 children, demonstrating microlithiasis of the gallbladder. Each child had a laparoscopic cholecystectomy with intraoperative cholangiogram. No abnormalities were seen on intraoperative cholangiogram. All 3 children had alleviation of pain and improvement of symptoms in postoperative follow-up.. Children with biliary microlithiasis and associated clinical symptoms can be successfully treated with laparoscopic cholecystectomy. Endoscopic ultrasound should be considered in the evaluation of the child with clinical biliary symptoms and a negative transabdominal ultrasound result.

Topics: Adolescent; Age of Onset; Antibiotic Prophylaxis; Ceftriaxone; Child; Cholagogues and Choleretics; Cholangiography; Cholangiopancreatography, Magnetic Resonance; Cholecystectomy, Laparoscopic; Cholelithiasis; Combined Modality Therapy; Comorbidity; Endosonography; False Negative Reactions; Female; Follow-Up Studies; Humans; Male; Neurosurgical Procedures; Pancreatitis; Postoperative Complications; Radiography, Interventional; Retrospective Studies; Technetium Tc 99m Lidofenin; Tomography, X-Ray Computed; Ursodeoxycholic Acid

AIDS patients are susceptible to opportunistic gastrointestinal infections including ascending cholangitis and cholecystitis, especially if CD4 count is < 200. Incidence of acalculous cholecystitis has not been reported previously.. We aim to evaluate the incidence of acalculous cholecystitis in AIDS patients and to identify causative organisms and mortality rate following cholecystectomy.. We reviewed the files of 46 patients in order to meet the objectives of this study.. CD4 counts were < 200 in 31 patients and > 200 in 15 patients. HIDA imaging was performed in 31 patients; in 8, the CD4 count was > 200 and all had calculous cholecystitis. The gallbladder was visualized in 3 patients for a sensitivity of 63% and no organisms were found in the gallbladder specimens. In 23 patients, the CD4 count was < 200; the gallbladder was visualized in 5 patients for a HIDA sensitivity of 78%; 16 (52%) had acalculous cholecystitis; and 15 had calculous cholecystitis. In acalculous cholecystitis, Cryptosporidium was found in six cases, cytomegalovirus (CMV) in six cases, and fungus, yeast, tuberculosis, and mycobacterium avium intracellular each in one case. The thirty day mortality rate was 18%; 5 of 28 who underwent open cholecystectomy died within 30 days, 4 of them with a CD4 count < 200. There was no mortality in the 26 patients who underwent laparoscopic cholecystectomy.. (1) Because of the high incidence of 52% of acalculous cholecystitis in AIDS patients with a CD4 count < 200, we recommend using intravenous cholecystokinin if the gallbladder is visualized on hepatobiliary scintigraphy in order to determine gallbladder ejection fraction and exclude acalculous cholecystitis. (2) Laparoscopic rather than open cholecystectomy should be the surgical procedure of choice in AIDS patients especially if the CD4 count is < 200.

Topics: Acquired Immunodeficiency Syndrome; Acute Disease; AIDS-Related Opportunistic Infections; CD4 Lymphocyte Count; Cholecystectomy; Cholecystitis; Cholelithiasis; Gallbladder; Humans; Radionuclide Imaging; Retrospective Studies; Sensitivity and Specificity; Technetium Tc 99m Lidofenin

Patients referred to general surgeons for the treatment of gall-bladder stones were studied to evaluate the role of sincalide cholescintigraphy as a gall-bladder stress test in an effort to identify a group of patients whose pain was non-biliary in origin and who would not be improved by cholecystectomy.. Ten asymptomatic controls and 57 patients with gallstones and abdominal symptoms were studied. All patients were interviewed by an independent assessor who identified a group of patients in whom the role of gallstones in their presentation was uncertain (clinically possibly biliary group). All patients and controls underwent sincalide cholescintigraphy. The surgeons remained blinded to the study results throughout the study period. All patients were re-evaluated 6-12 months later to establish the ultimate diagnosis based on their therapeutic response.. Several parameters of gall-bladder function were studied from analysis of the sincalide cholescintigram. Lag time, ejection period, ejection rate and ejection fraction did not differ significantly among controls, patients proven to have non-biliary disease and patients proven to have biliary disease. There were significant differences in mean gall-bladder filling fraction between proven biliary and proven non-biliary groups. However, the group of patients with clinically possibly biliary symptoms could not accurately be separated into those who benefited from cholecystectomy and those who improved without surgery on the basis of this parameter.. Significant differences in gall-bladder filling fraction between symptomatic and asymptomatic gallstone patients were identified suggesting reduced gall-bladder compliance in symptomatic patients. However, the sincalide cholescintigram failed to emerge as a useful gall-bladder stress test. Even in the 1990s, assessment by an experienced surgeon appears to be the most appropriate way to select patients for cholecystectomy.

Topics: Abdominal Pain; Cholelithiasis; Gallbladder; Humans; Radionuclide Imaging; Radiopharmaceuticals; Sincalide; Technetium Tc 99m Lidofenin

Topics: Acute Disease; Cholecystitis; Cholelithiasis; Gangrene; Humans; Imino Acids; Liver; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Lidofenin; Ultrasonography

The authors report a case of a patient with acute acalculous cholecystitis whose cholescintigram was negative, but showed a pericholecystic photopenic halo. The diagnosis was confirmed by an In-111 WBC scan and histopathology.

Topics: Cholecystitis; Cholelithiasis; False Negative Reactions; Female; Humans; Imino Acids; Indium Radioisotopes; Leukocytes; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Lidofenin

Change in gallbladder contractility after biliary extracorporeal shock-wave lithotripsy (ESWL) may significantly influence the clearance of fragments after successful gallstone fragmentation. We assessed changes in gallbladder contractility in response to an oral fatty meal in 50 patients 1 month after biliary ESWL (all fragments were smaller than 3 mm) and also in a separate group of 10 patients 3 months after complete clearance of fragments. The prevalence of persistent lumen-obliterating contraction of the gallbladder after biliary ESWL also was analyzed in 325 patients. Gallbladder contractility remained unchanged in 30, increased in nine, and decreased in 11 of the 50 patients. The average reduction in the fasting gallbladder volume after lithotripsy was 28% (p less than .001). Gallbladder contractility remained unchanged 3 months after complete clearance of fragments in six of 10 patients studied separately. A decrease (n = 2) or increase (n = 2) in contractility was seen in the remaining patients. No significant difference occurred in the average ejection fraction of the gallbladder before lithotripsy and after complete clearance of the fragments. Thirty-four of the 325 patients who have so far undergone biliary ESWL had a completely contracted gallbladder with no lumen visible on sonography. The gallbladder returned to a relaxed state in half of these patients within 1-9 months. Thus, biliary ESWL did not significantly alter gallbladder contractility in 60% of patients. A significant reduction in the volume of the fasting gallbladder occurred after lithotripsy. Successful clearance of fragments did not improve the contractility of stonebearing gallbladders in the majority of patients.

Topics: Cholecystokinin; Cholelithiasis; Eating; Fasting; Gallbladder; Humans; Imino Acids; Lithotripsy; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Lidofenin; Ultrasonography

We prospectively performed nuclear biliary patency imaging (HIDA scanning) in 62 patients who had undergone endoscopic retrograde sphincterotomy for management of pancreaticobiliary disease with their gallbladders in situ. Elective cholecystectomy was not recommended because of advanced age, comorbidity, or absence of gallstones. All patients had patent cystic ducts at endoscopic retrograde cholangiopancreatography balloon cholangiography. Eighteen (29.1%) of 62 patients had nonvisualizing HIDA scans, and in 44 (70.9%) of 62 visualization was normal or delayed. Six cholecystectomies were required for colic (n = 1), acute cholecystitis (n = 4), and acute cholecystocholedochal fistula with cholangitis (n = 1). Among the patients with cholelithiasis and nonvisualization (n = 13), five (38.5%) required surgery, whereas only one (4.8%) of 21 patients with cholelithiasis and visualization required surgery. Nonvisualizing HIDA scans are frequent (30%) after endoscopic retrograde sphincterotomy and have no clinical relevance in patients without cholelithiasis but predict the need for cholecystectomy within 16 months in 38.5% of patients with cholelithiasis.

Topics: Aged; Cholangiopancreatography, Endoscopic Retrograde; Cholecystectomy; Cholelithiasis; Cholestasis, Extrahepatic; Cystic Duct; Female; Follow-Up Studies; Gallbladder; Gallstones; Humans; Imino Acids; Male; Organotechnetium Compounds; Radionuclide Imaging; Sphincterotomy, Transduodenal; Technetium Tc 99m Lidofenin

We have carried out simultaneous, quantitative measurements of absolute gallbladder (GB) storage and emptying in 6 subjects with gallstones, using a modified duodenal perfusion technique that incorporates technetium 99m-labeled diethyl phenylcarbamomethyl iminodiacetate (99mTc-HIDA) as a GB bile marker in addition to indocyanine green as a hepatic bile marker. The technique was validated by measuring duodenal recovery of 99mTc-HIDA (mean +/- SEM, 101% +/- 4%), and also by studying 2 subjects who had undergone cholecystectomy. During the first hour following an evening meal, cumulative GB ejection of 99mTc-HIDA in the 6 subjects with gallstones was 43% +/- 12%. This was accompanied by GB storage of most hepatic indocyanine green (70% +/- 5%) during each 10-min interval of that hour. During subsequent overnight fasting, storage of hepatic indocyanine green (89% +/- 2%) was accompanied by ejection of 99mTc-HIDA from the GB in 33 of the 66 hourly intervals. Since 'simultaneous' filling and emptying cannot occur through the cystic duct, the results suggest frequent alternations in absolute GB storage and emptying, a phenomenon more analogous to a bellows than to the conventional concept of a simple pump.

Topics: Aged; Bile; Cholelithiasis; Duodenum; Fasting; Feeding Behavior; Female; Gallbladder; Humans; Imino Acids; Indocyanine Green; Intubation, Gastrointestinal; Male; Middle Aged; Organometallic Compounds; Perfusion; Polyethylene Glycols; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Time Factors

Topics: Adult; Cholecystectomy; Cholecystitis; Cholelithiasis; Chronic Disease; Humans; Imino Acids; Liver; Organometallic Compounds; Radionuclide Imaging; Technetium Tc 99m Lidofenin

The article describes results of using dynamic hepatobiliary scintigraphy in 43 young patients with chronic calculous cholecystitis. High informative value of the method for diagnosis of morpho-functional changes in the organs of the hepatobiliary system is shown, hyperbilirubinemia included. More than in half of the patients alterations of the absorptive-excretory functions of the liver and motor function of the gallbladder were revealed. Their direct relationship with the duration of the disease and degree of the inflammatory process in the biliary tract is established.

Topics: Adult; Biliary Tract; Cholecystitis; Cholelithiasis; Chronic Disease; Evaluation Studies as Topic; Female; Humans; Imino Acids; Iodipamide; Liver; Male; Radiography; Technetium; Technetium Tc 99m Lidofenin; Tomography, Emission-Computed

Fifty-four patients with suspected acute cholecystitis underwent 99mTc HIDA cholescintigraphy, ultrasonography and oral cholecystography. The correct diagnosis was reached in 49 patients by cholescintigraphy (91%) in 35 (65%) by ultrasonography and in 45 (83%) by oral cholecystography. 99mTc HIDA cholescintigraphy provides a rapid accurate diagnosis with minimal discomfort to the patient and is the investigation of choice for patients with symptoms of acute gallbladder disease, particularly if early cholecystectomy is to be considered.

Topics: Acute Disease; Cholecystitis; Cholecystography; Cholelithiasis; False Positive Reactions; Gallbladder Diseases; Humans; Imino Acids; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Hepatic lithiasis is a major disease in Asia, especially East Asia. Its clinical aspect and incidence have been reviewed. The radionuclide methods ranging from sequential scintigraphy through hepatic retention ratio determination to retention ratio image would be simple and innocuous techniques for screening and detecting this disease.

Topics: Bile Duct Diseases; Cholangiography; Cholangitis; Cholelithiasis; Gallium Radioisotopes; Humans; Imino Acids; Organometallic Compounds; Radionuclide Imaging; Technetium Tc 99m Lidofenin

The records of 242 patients, operated consecutively for biliary lithiasis, were analyzed to determine the reliability of oral cholecystography (OCG), ultrasonography (US), and HIDA in detecting biliary calculi. Preoperative interpretations were correlated to operative findings. OCG obtained in 138 patients was accurate in 92%. US obtained in 150 was correct in 89%. The accuracy of HIDA was 92% in acute and 78% in chronic cholecystitis. Intraoperative cholangiography (IOC) done in 173 patients indicated the need for exploratory choledochotomy in 24; 21 had choledocholithiasis. These observations suggest that OCG and US are very accurate, but not infallible, in detecting cholelithiasis. US should be done first; when doubt persists, the addition of OCG allows the preoperative diagnosis of gallstones in 97% of the cases. HIDA is highly accurate but not infallible in detecting acute calculous cholecystitis. IOC is very reliable in detecting choledocholithiasis; thus, its routine is justifiable.

Topics: Adolescent; Adult; Aged; Cholangiography; Cholecystectomy; Cholecystography; Cholelithiasis; Common Bile Duct; Diagnostic Errors; Female; Gallstones; Humans; Imino Acids; Intraoperative Period; Male; Middle Aged; Radionuclide Imaging; Retrospective Studies; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Computer-assisted 99mTc-HIDA cholescintigraphy was performed before and after elective cholecystectomy in 24 patients. Preoperative cholecystography had shown gallstones in a well visualized gallbladder in 12 of the patients, and in 12 the gallbladder had not been visualized. Liver function tests gave normal results in all 24 patients, and peroperative cholangiography showed no common duct stones in any patient. In the series with functioning gallbladder, comparison of the preoperative and postoperative scintigrams showed that cholecystectomy was followed by significantly earlier visualization of the lower part of the common duct and of the duodenum. The number of times that passage of activity to the duodenum was observed also rose significantly. Comparison of the time-activity curves showed that after cholecystectomy the liver activity reached its maximum value significantly earlier post-injection as compared with the preoperative values. All of these changes were absent in the series with nonfunctioning gallbladder. Removal of a functioning gallbladder results in accelerated, though still irregular flow of activity to the duodenum.

Topics: Adult; Aged; Bile; Cholecystectomy; Cholecystography; Cholelithiasis; Female; Gallbladder; Humans; Imino Acids; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Altered gallbladder motility could predispose to, or result from, gallstone formation and could also explain the alleged relief of biliary colic seen during bile acid therapy. Therefore, in 14 controls, 25 patients with radiolucent gallstones, and 14 patients with radiopaque gallstones, we used two techniques to measure gallbladder contraction--radionuclide imaging and real-time ultrasound--in response to one of two stimuli--a Lundh meal or intravenous cholecystokinin-octapeptide. Using the radionuclide technique, postprandial gallbladder emptying (t1/2) was prolonged (p less than 0.01) both in patients with radiopaque (26.7 +/- 3.1 min, mean +/- SEM) and radiolucent (21.7 +/- 3.1) gallstones when compared with controls (10.2 +/- 1.5). In patients with radiolucent stones, the t1/2 of gallbladder emptying became further prolonged (p less than 0.05) after 1 mo of therapy with 8-10 mg/kg body wt X day of ursodeoxycholic acid, to 32.1 +/- 4.4 min. A similar pattern of results was seen after cholecystokinin-octapeptide and also with real-time ultrasound. Thus, after both stimuli and using two independent techniques, gallbladder contraction was reduced in patients with gallstones. The slower and less complete gallbladder emptying with ursotherapy might explain the reduction in biliary colic noted during treatment.

Topics: Adult; Aged; Cholelithiasis; Deoxycholic Acid; Eating; Female; Gallbladder; Humans; Imino Acids; Infusions, Parenteral; Male; Middle Aged; Muscle Contraction; Radionuclide Imaging; Sincalide; Technetium; Technetium Tc 99m Lidofenin; Time Factors; Ultrasonography; Ursodeoxycholic Acid

The value of infusion cholecystography 99mTc HIDA cholescintigraphy and ultrasonography was compared in 51 patients presenting with a clinical diagnosis of acute cholecystitis. Of the 35 patients with proven gallbladder disease, the presence of gallstones was correctly predicted in 31 (88 per cent) by infusion cholecystography, 32 (90 per cent) by 99mTc HIDA cholescintigraphy and 27 (77 per cent) by ultrasonography. There were no false positive investigations. Infusion cholecystography may be of particular interest to surgeons with no ready access to isotope scanning techniques.

Topics: Acute Disease; Cholecystitis; Cholecystography; Cholelithiasis; Contrast Media; Gallbladder Diseases; Humans; Imino Acids; Iodobenzoates; Ioglycamic Acid; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

The authors note high significance of results of echocholescintigraphy in diagnosis of acute and chronic calculous cholecystitis. Preoperative echographic diagnosis of destructive changes in the gall bladder wall was shown to be possible.

Topics: Adult; Aged; Cholecystitis; Cholelithiasis; False Negative Reactions; Female; Gallbladder; Humans; Imino Acids; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

A study was undertaken to establish the pattern of gallbladder emptying in normal subjects and in patients with gallstones, using a fatty meal as stimulus to release endogenous cholecystokinin. The time from meal ingestion to beginning of gallbladder emptying (latent period), the total duration of emptying (ejection period), degree of emptying (ejection fraction), and the rate of emptying (ejection fraction/ejection period) were measured noninvasively by a nongeometric scintigraphic technique. The mean latent period and ejection rate were similar in normal subjects and patients with gallstones, but the mean ejection period and ejection fraction were significantly reduced in the patients. This study suggests that for an identical stimulus, the gallbladder in cholelithiasis begins to empty at the normal time but empties for a shorter duration; the result is a reduction of ejection fraction but not of ejection rate.

Topics: Adult; Aged; Bile; Cholelithiasis; Computers; Dietary Fats; Gallbladder; Humans; Imino Acids; Kinetics; Male; Middle Aged; Muscle Contraction; Radionuclide Imaging; Statistics as Topic; Technetium; Technetium Tc 99m Disofenin; Technetium Tc 99m Lidofenin

Tc-99m IDA cholescintigraphy frequently provides information regarding nonbiliary pathology, such as small bowel obstruction. The cholescintigraphic finding of functional cystic duct obstruction concomitant with persistent small bowel dilatation and lack of progression of labeled bile suggests the diagnosis of gallstone ileus.

Topics: Aged; Cholelithiasis; Cholestasis, Extrahepatic; Cystic Duct; Female; Humans; Imino Acids; Intestinal Obstruction; Jejunal Diseases; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

A method is presented of calculating the flow of 99mTc-labelled IDA derivates in intra- and extrahepatic bile ducts. By computer means the superimposed liver parenchymal activity is subtracted from the original sequence data in each pixel and at each time. In addition to known evaluation methods, the described procedure seems to be helpful for clinical application in order to better display anatomical details of intrahepatic structures like bile ducts and to calculate quantitative parameters like appearance times in intra- and extrahepatic regions. Examples are given and the possibility of calculating a gallbladder filling rate for separating normal gallbladders from stone-filled ones is statistically proven.

Topics: Adult; Bile Ducts; Bile Ducts, Intrahepatic; Cholelithiasis; Female; Gallbladder; Humans; Imino Acids; Methods; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Technetium-99m iminodiacetic acid (IDA) cholescintigraphy was performed in 15 patients with acute acalculous cholecystitis. Fourteen of the 15 patients with acute disease had positive findings, indicating the presence of cystic duct or common duct obstruction. One case in which the gallbladder was visualized failed to respond to sincalide stimulation; this was classified as a suggestive finding of disease. The diagnostic accuracy of 99mTc-IDA cholescintigraphy was far superior to the other imaging studies used (8 sonograms, 1 intravenous cholangiogram, 3 oral cholecystograms, 1 percutaneous transhepatic cholangiogram). The 99mTc-IDA study is recommended as the imaging procedure of choice for examining patients with suspected acute acalculous cholecystitis.

Topics: Acute Disease; Aged; Cholecystitis; Cholelithiasis; Cholestasis; Female; Gallbladder; Humans; Imino Acids; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin; Technetium Tc 99m Lidofenin

We used a Tc-99m-labeled hepatobiliary agent to measure the partition of hepatic bile between gallbladder and intestine in sixteen normal patients and nine patients with cholelithiasis. In normal subjects, the fractions of the hepatic bile that flow into the gallbladder and the small intestine were widely variable, with mean values of 69 +/- 7% (s.e.) and 31 +/- 7% respectively. Bile reflux into the common hepatic duct was rare, occurring during the first 2/3 of the gallbladder ejection period and only when the ejection fraction was greater than 59%. The gallbladder's mean latent period, ejection period, ejection fraction, and ejection rate were 2 +/- 1 min, 11 +/- 1 min, 59 +/- 4%, and 5.9%/min respectively. In patients with cholelithiasis, the fraction of hepatic bile flowing into the gallbladder was normal, but the ejection fraction was significantly reduced (p less than 0.005). For an equivalent dose of cholecystokinin, the gallbladder in cholelithiasis is less responsive than in normal subjects.

Topics: Adult; Animals; Bile Reflux; Cholecystokinin; Cholelithiasis; Female; Gallbladder; Hepatic Duct, Common; Humans; Imino Acids; Male; Middle Aged; Rabbits; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Technology, Radiologic

Topics: Abdominal Injuries; Animals; Biliary Tract Diseases; Cholelithiasis; Cholestasis, Extrahepatic; Cholestasis, Intrahepatic; Dogs; Female; Imino Acids; Liver Diseases; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Wounds, Penetrating

The recent availability of iminodiacetic acid analogues labeled with technetium Tc 99m provides a safe and accurate noninvasive test of biliary function. Biliary scintigraphy is a simple and rapid method of detecting acute cholecystitis in particular but also of distinguishing acute biliary pancreatitis from nonbiliary pancreatitis, of evaluating the patency of the common duct in early obstruction, of assessing possible postcholecystectomy syndrome, of evaluating the patency of a biliary enteric bypass, and of detecting postoperative biliary leaks.

Topics: Acute Disease; Biliary Tract; Biliary Tract Diseases; Biliary Tract Surgical Procedures; Cholecystitis; Cholelithiasis; Cholestasis; Humans; Imino Acids; Methods; Postoperative Complications; Radiography; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Radionuclide hepatobiliary imaging (HIDA scanning), a pathophysiologic modality, has become the diagnostic method of choice for suspected acute cholecystitis. The diagnosis is made quickly with this technic, which is simple, safe, and accurate. It is in widespread use and will soon be available for small community hospitals as well as large metropolitan and university centers. Ultrasound, though an excellent anatomic modality for diagnosing cholelithiasis, does not demonstrate the status of the cystic duct, information essential to the diagnosis of acute cholecystitis.

Topics: Acute Disease; Cholecystitis; Cholelithiasis; Cystic Duct; Evaluation Studies as Topic; Gallbladder; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Tc-99m biliary imaging was performed on a 34-year-old woman who was being investigated for suspected cholelithiasis. A left-sided liver was detected. On subsequent radionuclide imaging, partial visceral situs inversus and asplenia were demonstrated. Extensive roentgenographic investigation, ECG, echocardiogram, and laparotomy confirmed the radionuclide findings. Asplenia syndrome may exist without cardiovascular abnormalities and thus be undiscovered. Radionuclide imaging is important in the diagnosis of this syndrome.

Topics: Adult; Biliary Tract; Cholelithiasis; Echocardiography; Electrocardiography; Female; Heart; Humans; Imino Acids; Radionuclide Imaging; Situs Inversus; Spleen; Syndrome; Technetium; Technetium Tc 99m Lidofenin

Topics: Cholelithiasis; Cystic Duct; False Negative Reactions; Female; Humans; Imino Acids; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Topics: Adult; Aged; Cholecystitis; Cholelithiasis; Chronic Disease; Female; Gallbladder; Humans; Imino Acids; Male; Middle Aged; Radiography; Technetium; Technetium Tc 99m Lidofenin; Tomography, Emission-Computed

Topics: Acute Disease; Aged; Cholecystitis; Cholecystography; Cholelithiasis; Gallbladder Diseases; Humans; Imino Acids; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Topics: Acute Disease; Cholecystitis; Cholelithiasis; Gallbladder; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Topics: Acute Disease; Biliary Tract; Cholecystitis; Cholecystography; Cholelithiasis; Humans; Imino Acids; Liver Function Tests; Pancreatitis; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin