technetium-tc-99m-lidofenin and Common-Bile-Duct-Diseases

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

Sphincter of Oddi dysfunction is diagnosed at manometry and, after cholecystectomy, non-invasively at quantitative choledochoscintigraphy. Patients may benefit from endoscopic sphincterotomy.. The aim of this study was to assess the usefulness of choledochoscintigraphy compared with manometry in predicting outcome of sphincterotomy in post cholecystectomy patients with sphincter of Oddi dysfunction.. Thirty patients with biliary-type pain complying with the Rome diagnostic criteria of sphincter of Oddi dysfunction and belonging to biliary group I and II were subjected to clinical evaluation, choledochoscintigraphic assessment of the hepatic hilum-duodenum transit time, endoscopic retrograde cholangiopancreatography, and perendoscopic manometry. Twenty two biliary group I and II patients with prolonged hepatic hilum-duodenum transit times were invited to undergo sphincterotomy. Fourteen patients underwent sphincterotomy; eight refused. Clinical and scintigraphic assessments were performed at follow up.. Hepatic hilum-duodenum transit time was delayed in all patients with manometric evidence of sphincter of Oddi dysfunction, in all biliary group I patients and in 64% of biliary group II patients. At follow up, all patients who underwent sphincterotomy were symptom free and hepatic hilum-duodenum transit time had either normalised or significantly improved. A favourable post sphincterotomy outcome was predicted in 93% of cases at choledochoscintigraphy and in 57% at manometry.. Quantitative choledochoscintigraphy is a useful and non-invasive test to diagnose sphincter of Oddi dysfunction as well as a reliable predictor of sphincterotomy outcome in post cholecystectomy biliary group I and II patients, irrespective of clinical classification and manometric findings.

Topics: Adult; Aged; Bile; Cholecystectomy; Common Bile Duct Diseases; Female; Follow-Up Studies; Humans; Male; Manometry; Middle Aged; Prognosis; Radionuclide Imaging; Sphincter of Oddi; Sphincterotomy, Endoscopic; Technetium Tc 99m Lidofenin; Treatment Outcome

Topics: Common Bile Duct Diseases; Gastrointestinal Transit; Humans; Imino Acids; Morpholines; Organotechnetium Compounds; Parasympatholytics; Radionuclide Imaging; Sphincter of Oddi; Technetium Tc 99m Lidofenin

Topics: Common Bile Duct; Common Bile Duct Diseases; Humans; Imino Acids; Infant; Male; Organotechnetium Compounds; Radionuclide Imaging; Rupture, Spontaneous; Technetium Tc 99m Lidofenin; Ultrasonography

A total of 25 children with bronchial asthma and 40 children with cutaneous and dermato-respiratory + manifestations of allergy and concomitant injury to the gastrointestinal tract were under observation at an allergological clinic. In addition to the general clinical and allergological examination, radionuclide studies were performed by means of scintipneumography with 99mTc and hepatobiliscintigraphy with 99mTc HIDA. The data obtained indicate that radionuclide methods can be used in childhood allergological practice in the capacity of screening diagnosis as well as in the capacity of adjuvant + methods of examination, making it possible to perform investigations necessary for diagnosis establishment in a more precise and atraumatic manner.

Topics: Asthma; Biliary Dyskinesia; Child; Child, Preschool; Common Bile Duct Diseases; Dermatitis, Atopic; Food Hypersensitivity; Gallbladder Diseases; Humans; Imino Acids; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Lidofenin

The authors describe radiologic findings in five patients with spontaneous perforation of the common bile duct (a rare disorder). The patients were 5 weeks, 9 weeks, 3 months, 11 months, and 2 1/2 years old at presentation. The most common presenting complaints were jaundice and abdominal distention (due to ascites). Sonographic findings included ascites in three patients, a loculated fluid collection around the gallbladder in two patients, and both in one patient. The biliary tree was undilated in all patients. Results of hepatobiliary scintigraphy definitely demonstrated that intraperitoneal fluid originated from the biliary tract. Intraoperative cholangiography was used to confirm the diagnosis at surgery. All children were successfully treated with surgery. Recognition of these findings on sonograms and subsequent confirmation with scintigraphy are important to prevent delays in diagnosis of a potentially fatal condition.

Topics: Child, Preschool; Cholangiography; Common Bile Duct Diseases; Female; Humans; Imino Acids; Infant; Intraoperative Care; Male; Organometallic Compounds; Organotechnetium Compounds; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Topics: Child; Child, Preschool; Common Bile Duct Diseases; Cysts; Female; Humans; Imino Acids; Infant; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

A cyst of the common bile duct, the most frequent variant of cystic dilatation of the extrahepatic biliary tract, presents a serious diagnostic problem. Using serial scintigraphy with 99mTc-HIDA 13 children with cysts of the common bile duct confirmed by the results of operative cholangiography, were examined. In 8 of them a radionuclide study was performed at varying times after operation (cyst extirpation with the establishing of hepatoenteroanastomosis--4 patients, and variants of internal drainage operations--4 patients). Typical scintigraphic signs were the following: sacculated or spheroidal dilatation of the common bile duct in combination with dilatation of the left (7), right (1) or both lobular bile ducts, absence of the gall bladder visualization. In the first 15 min of examination in large size cysts zones of the lowered accumulation of the radiopharmaceutical agent were revealed in the area of the portal fissure. Indicators of absorptive-excretory hepatic function changed mainly in children with spheroid-shaped cysts demonstrating alongside with the time of intestinal visualization the degree of disorder of permeability of the choledoch distal parts. The recovery of the anatomic-functional state of the biliferous system occurred earlier (up to 1.5 year) in children after cyst extirpation than after internal drainage operations. It manifested itself in returning the diameter of the bile ducts to normal and in the improvement of absorptive-excretory hepatic function.

Topics: Child; Child, Preschool; Common Bile Duct Diseases; Cysts; Female; Humans; Imino Acids; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

The diagnostic possibility of hypertonic Oddi's sphincter dysfunction was evaluated in 100 cholecystectomized and 28 noncholecystectomized patients. An organic lesion interfering with free bile flow was ruled out in every case. The existence of the syndrome, i.e., the dysfunction of the Oddi's musculature, was verified using the morphine-choleretic test combined with either dynamic hepatobiliary scintigraphy or (in selected cases) percutaneous transhepatic cholangiography. Hypertonic Oddi's sphincter dyskinesia can be regarded as an independent clinical syndrome.

Topics: Ampulla of Vater; Amylases; Aspartate Aminotransferases; Cholecystectomy; Common Bile Duct Diseases; Dehydrocholic Acid; gamma-Glutamyltransferase; Humans; Imino Acids; Morphine; Movement Disorders; Muscle Hypertonia; Postoperative Complications; Radiography; Sphincter of Oddi; Syndrome; Technetium; Technetium Tc 99m Lidofenin

Cystic dilatations of the biliary tract are rare anomalies. In the individual case, diagnosis may pose great problems. The relevance of the various methods was assessed in eight patients investigated with different diagnostic methods. In all patients the predominant symptom was uncharacteristic upper abdominal complaints. Two patients showed intermittent jaundice. Among non-invasive methods sonography is preeminent and permits precise demonstration of intra- and extrahepatic biliary duct dilatations. It can be complemented by CAT-scanning. Whereas intravenous cholegraphy does not permit sufficient ascertainment of the diagnosis, ERCP and PTC allow precise demonstration of the anomaly. Functional hepatobiliary scanning is indicated where endoscopic methods are not available. Among the eight patients sonography was decisively relevant in five cases and ERCP in all cases. The remaining functional assessments furnished important additional informations.

Topics: Adolescent; Adult; Child; Cholangiopancreatography, Endoscopic Retrograde; Common Bile Duct Diseases; Cysts; Female; Humans; Imino Acids; Magnetic Resonance Spectroscopy; Technetium; Technetium Tc 99m Lidofenin; Tomography, X-Ray Computed; Ultrasonography

The diagnosis of papillary stenosis, occasionally seen after cholecystectomy, is confirmed by endoscopic retrograde cholangiopancreatography (ERCP), which demonstrates delayed emptying of contrast material into the duodenum for more than 45 minutes. The authors assessed 2,6-dimethyl phenyl carbamoyl methyl iminodiacetic acid labelled with technetium-99m (99mTc HIDA) as a less invasive procedure in these circumstances by comparing it with the findings from ERCP. Twenty-six patients who had pain after cholecystectomy were studied by continuous 1-hour scintigraphy after injection of 99mTc HIDA. Biliary flow was estimated by measuring uptake and clearance of the entire liver and common bile duct. Volunteers who had no pain after cholecystectomy served as controls. Of the 26 study patients, all 99mTc HIDA scan findings were within the control range in 11. Of these, 10 had normal biliary drainage confirmed by ERCP. The one patient with delayed drainage did not improve after endoscopic sphincterotomy. Two patients demonstrated pooling of 99mTc HIDA in cystic dilatations of the biliary tree, while the other 13 patients had obstruction of the distal common bile duct and impaired flow demonstrated on the 99mTc HIDA scan. All 13 of these patients had papillary stenosis proven by ERCP. The authors conclude that 99mTc HIDA scanning is a valuable, minimally invasive method of diagnosing papillary stenosis.

Topics: Ampulla of Vater; Cholangiopancreatography, Endoscopic Retrograde; Cholecystectomy; Common Bile Duct Diseases; Constriction, Pathologic; Humans; Imino Acids; Pain, Postoperative; Postoperative Complications; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Twelve patients with choledochal cyst have undergone intravenous radionuclide cholescintigraphy (IVRC) with Tc-99m-labeled HIDA or PG before surgery. The most characteristic findings are: (1) A round or ovoid photon-deficient area in the region of the gallbladder in the early images; (2) progressive accumulation of radioactivity in the same region in later images, especially at 2 hr after injection; (3) the long axis of this particular area directed downward and to the patient's left from the right midclavicular line, suggesting the direction of the common bile duct; and (4) persistent pooling of the tracer up to 24 hr, even after a fatty meal. By these criteria, correct diagnoses have been made preoperatively in ten of 12 cases (83.3%). We conclude that IVRC using Tc-99m HIDA or Tc-99m PG is an excellent first-line diagnostic tool for choledochal cyst.

Topics: Adolescent; Adult; Child; Child, Preschool; Common Bile Duct; Common Bile Duct Diseases; Cysts; Evaluation Studies as Topic; Female; Gallbladder; Glutamates; Humans; Imino Acids; Male; Middle Aged; Organotechnetium Compounds; Pyridoxal; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Time Factors

Three cases of choledochal cyst associated with intrahepatic biliary dilatation are presented. Findings on sonography included a large cystic mass in the porta hepatis separate from the gallbladder; a dilated common hepatic or common bile duct entering directly into the cyst; the smaller cystic masses of dilated central intrahepatic ducts. The dilatation of the central intrahepatic bile ducts was moderate in two patients and massive in one patient. All three patients underwent operation with intraoperative cholangiography. Two patients had 99mTc IDA cholescintigraphy which confirmed the diagnosis of choledochal cyst by demonstrating filling of the cyst with stasis and delayed intestinal activity. The accurate preoperative diagnosis of choledochal cyst, made by sonography combined with 99mTc IDA cholescintigraphy, obviated invasive studies.

Topics: Bile Duct Diseases; Bile Ducts, Intrahepatic; Child; Child, Preschool; Common Bile Duct Diseases; Cysts; Dilatation, Pathologic; Female; Humans; Imino Acids; Male; Organotechnetium Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

An unusual case of malignant degeneration of a choledochal cyst is presented. The presence of acute cholecystitis with the cystic duct originating from the cyst as well as the subsequent obstruction of the cyst-jejunal surgical anastomosis was readily detected with Tc-99m-dimethyl-iminodiacetic (Tc-99m-HIDA) cholescintigraphy.

Topics: Adult; Cholecystitis; Common Bile Duct; Common Bile Duct Diseases; Cysts; Female; Gallbladder; Humans; Imino Acids; Jejunum; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Many new radiographic procedures have recently been widely introduced which should make the diagnosis of cystic of the biliary tree a preoperative rather than an operative diagnosis. A case is presented emphasizing the value of these procedures.

Topics: Adult; Common Bile Duct Diseases; Cysts; Female; Humans; Imino Acids; Technetium; Technetium Tc 99m Lidofenin; Tomography, X-Ray Computed; Ultrasonography

Topics: Adult; Common Bile Duct Diseases; Cysts; Female; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Topics: Child; Cholangiography; Common Bile Duct Diseases; Cysts; Humans; Imino Acids; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin