technetium-tc-99m-mebrofenin and Cholelithiasis

Radiographic diagnosis of acute cholecystitis can be established using ultrasonography (US), cholecystoscintigraphy (HIDA), or both. Although both modalities have been effective in diagnosing acute cholecystitis (AC), physicians from the emergency department and admitting surgeons continue to request both tests in an attempt to increase the diagnostic accuracy of AC. This article reports the institutional experience of a large tertiary care health care facility, with respect to the sensitivity of US, HIDA, and combined US and HIDA.. We conducted a retrospective review of 132 patients diagnosed with AC who underwent laparoscopic cholecystectomy during the same hospitalization. Patients were stratified into three groups: Group 1 (Gp1, n = 50) included patients who underwent US alone, group 2 (Gp2, n = 28) included patients who underwent HIDA scan alone, and group 3 (Gp3, n = 54) included patients who underwent both US and HIDA.. The three groups did not differ with respect to age, liver chemistry, time to operation, and hospital length of stay. The sensitivity of US, HIDA, and combined US/HIDA as diagnostic modalities for acute cholecystitis was referenced to histopathologic confirmation. Sensitivity was 24 of 50 (48%), 24 of 28 (86%), and 49 of 54 (90%) for US, HIDA, and the combination of US/HIDA, respectively.. HIDA scan is a more sensitive test than US in diagnosing patients with AC. Based on the results of this study, we recommend that HIDA scan should be used as the first diagnostic modality in patients with suspected acute cholecystitis; US should be used to confirm the presence of gallbladder stones rather than to diagnose AC.

Topics: Acute Disease; Adult; Aged; Aniline Compounds; Cholecystectomy, Laparoscopic; Cholecystitis; Cholelithiasis; Female; Glycine; Humans; Imino Acids; Length of Stay; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Sensitivity and Specificity; Ultrasonography

Topics: Adult; Aniline Compounds; Bile; Bile Ducts; Cholecystectomy, Laparoscopic; Cholelithiasis; Female; Gallbladder; Glycine; Humans; Imino Acids; Kidney Transplantation; Liver; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals

Topics: Abdominal Pain; Adult; Aniline Compounds; Artifacts; Cholelithiasis; Colon; Diagnosis, Differential; Gallbladder; Glycine; Humans; Imino Acids; Male; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Ultrasonography

Visualization of a "dilated cystic duct" during standard hepatobiliary imaging represents a potential source of false-negative cholescintigraphy. Intravenous morphine, commonly used to shorten study time and improve the specificity of hepatobiliary imaging, may, by virtue of its pharmacologic/physiologic actions, accentuate the appearance of a "dilated cystic duct." We present a case of transient cystic duct visualization following morphine administration in a patient with an obstructing cystic duct calculus.

Topics: Adult; Aniline Compounds; Cholelithiasis; Cholestasis, Extrahepatic; Cystic Duct; False Negative Reactions; Female; Gallbladder; Glycine; Humans; Imino Acids; Liver; Morphine; Organotechnetium Compounds; Radionuclide Imaging

A total of 103 patients with cholelithiasis and those operated on one year ago were investigated using modified cholescintigraphy permitting the determination of a size, duration and spreading of the gastroduodenal reflux. Dynamic cholescintigraphy was shown to be an effective method of the diagnosis and quantitative estimation of the gastroduodenal reflux in patients with cholelithiasis and patients after cholecystectomy. In patients with the postcholecystectomy syndrome the gastroduodenal reflux was detected more frequently, and its quantitative indicators were lower than those in patients with cholelithiasis.

Topics: Adult; Aged; Aniline Compounds; Cholecystectomy; Cholelithiasis; Duodenogastric Reflux; Female; Glycine; Humans; Imino Acids; Male; Middle Aged; Organotechnetium Compounds; Postoperative Complications; Radionuclide Imaging