An update in radionuclide imaging in the diagnosis of cholecystitis

H. S. Weissmann, R. Rosenblatt, L. A. Sugarman, Leonard M. Freeman

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Over 90% of cases of acute cholecystitis are associated with cystic-duct obstruction. A procedure which reliably documents cystic obstruction would be ideal. A cholescintigram utilizing technetium Tc-99m-labeled acetanilide iminodiacetic acid (99mTc-IDA) has been shown to have the highest accuracy and sensitivity in documenting acute cystic obstruction. The major imaging hallmark of chronic cholecystitis is cholelithiasis (gallstones plus chronic inflammatory changes occur in 90% of cases), and the combination of oral cholecystography and ultrasonography represents the best ideal imaging. Intravenous cholangiography is less and less used due to its significant morbidity and mortality, potential hepatic and renal toxicity, poor diagnostic accuracy and impaired visualization when hyperbilirubinemia is present. Ultrasonography reveals calculi as small as 2 to 3 mm as well as gallbladder irregularity and thickening. When the gallbladder, common bile-duct and duodenum are visualized within one hour, acute cholecystitis can be excluded with almost 100% accuracy. When visualization of gallbladder fails to occur despite normal hepatic uptake and common-duct visualization, cystic duct-obstruction is present. Additional views up to 4 hours are important to exclude delayed visualization. (Mattas - Sao Paulo)

Original languageEnglish (US)
Pages (from-to)1354-1357
Number of pages4
JournalJournal of the American Medical Association
Volume246
Issue number12
DOIs
StatePublished - 1981

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Cholecystitis
Gallbladder
Radionuclide Imaging
Cystic Duct
Acute Cholecystitis
Ultrasonography
Cholecystography
Common Hepatic Duct
Hyperbilirubinemia
Cholelithiasis
Cholangiography
Technetium
Calculi
Common Bile Duct
Gallstones
Duodenum
Morbidity
Kidney
Mortality
Liver

ASJC Scopus subject areas

  • Medicine(all)

Cite this

An update in radionuclide imaging in the diagnosis of cholecystitis. / Weissmann, H. S.; Rosenblatt, R.; Sugarman, L. A.; Freeman, Leonard M.

In: Journal of the American Medical Association, Vol. 246, No. 12, 1981, p. 1354-1357.

Research output: Contribution to journalArticle

Weissmann, H. S. ; Rosenblatt, R. ; Sugarman, L. A. ; Freeman, Leonard M. / An update in radionuclide imaging in the diagnosis of cholecystitis. In: Journal of the American Medical Association. 1981 ; Vol. 246, No. 12. pp. 1354-1357.
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