Abstract
We investigated the effect of the severity of chronic cholecystitis on the incidence of false positive cholescintigrams in the diagnosis of acute cholecystitis. In a 4-year period 66 patients underwent cholescintigraphy (without evidence of significant hepatocellular disease or biliary tract obstruction) followed within 6 days by surgical removal of the gallbladder. At histopathology the gallbladders were categorized as normal, acute cholecystitis, or chronic cholecystitis. In addition, the severity of chronic cholecystitis was graded on a three-point scale. Using nonvisualization of the gallbladder for up to 4 h as the criterion for acute cholecystitis, the sensitivity and specificity for acute cholecystitis were 97 and 66%, respectively. Of the 35 gallbladders without acute cholecystitis, 4 were normal and the rest had various grades of chronic cholecystitis. The incidence of false positive studies increased with the severity of chronic cholecystitis (p<0.05). In addition, there were no false positive studies among the normal gallbladders and all gallbladders with grade three chronic cholecystitis gave false positive results. The data suggests that the severity of chronic cholecystitis affects the likelihood of obtaining false positive results with cholescintigraphy in the diagnosis of acute cholecystitis.
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References
Freitas JE, Coleman RE, Nagle CE, Bree RL, Krewer KD, Gross MD: Influence of scan and pathologic criteria on the specificity of cholescintigraphy.J Nucl Med 24:876–879, 1983
Worthen NJ, Uszler JM, Funamura JL: Cholecystitis: prospective evaluation of sonography and 99mTc-HIDA cholescintigraphy.AJR 137:973–978, 1981
Samuels BJ, Freitas JE, Gross MD: A pragmatic review of gallbladder imaging.Sem Ultrasound CT MR 6:156–171, 1985
Fajman WA: Acute right upper quadrant abdominal pain: radionuclide approach.J Clin Ultrasound 11:193–200, 1983
Austin H: Acute right upper quadrant abdominal pain: ultrasound approach.J Clin Ultrasound 11:187–192, 1983
Stadalnik RC, Kraus JF, Matolo M, Krohn KA: The validity of 99mTc-pyridoxylideneglutamate (P.G.) cholescintigraphy as a diagnostic test for cholecystitis.Clin Nucl Med 3:142–146, 1978
Weissmann HS, Frank MS, Bernstein LH, Freeman LM: Rapid and accurate diagnosis of acute cholecystitis with 99mTc-HIDA cholescintigraphy.AJR 132:523–528, 1979
Weissmann HS, Badia J, Sugarman LA, Kluger L, Rosenblatt R, Freeman LM: Spectrum of 99m-Tc-IDA cholescintigraphic patterns in acute cholecystitis.Radiology 138:167–175, 1981
Fonseca C, Greenberg D, Rosenthal L, Arzoumanian A: Assessment of the utility of gallbladder imaging with 99Tc-IDA.Clin Nucl Med 3:437–441, 1978
Suarez CA, Block F, Bernstein D, Serafini A, Rodman G, Zeppa R: The role of H.I.D.A./P.I.P.I.D.A. scanning in diagnosing cystic duct obstruction.Ann Surg 191:391–396, 1980
Samuels BI, Freitas JE, Bree RL, Schwab RE, Heller ST: A comparison of radionuclide hepatobiliary imaging and realtime ultrasound for the detection of acute cholecystitis.Radiology 147:207–210, 1983
Larsen MJ, Klingensmith WC, Kuni CC: Radionuclide hepatobiliary imaging: non-visualization of the gallbladder secondary to prolonged fasting.J Nucl Med 23:1003–1005, 1982
Shuman WP, Gibbs P, Rudd TG, et al.: PIPIDA scintigraphy for cholecystitis: False positives in alcoholism and total parenteral nutrition.AJR 138:1–5, 1982
Klingensmith WC, Fritzberg AR, Zerbe GO, Koep LP: Relative role of Tc-99m-diethyl-IDA and Tc-99m-sulfur colloid in the evaluation of liver function.Clin Nucl Med 5:341–346, 1980
Klingensmith WC, Spitzer VM, Fritzberg AR, Kuni CC: The normal fasting and postprandial Tc-99m-diisopropyl-IDA hepatobiliary study.Radiology 141:791–795, 1981
Klingensmith WC, Fritzberg AR, Spitzer VM, Kuni CC, Williamson MR, Gerhol JP: Clinical evaluation of Tc-99mtrimethylbromo-IDA and Tc-99m-diisopropyl-IDA for hepatobiliary imaging.Radiology 146:181–184, 1983
Sippo WC, Moreno AJ, Cabellon S, Turnbull GL: The effect of prolonged fasting and total parenteral nutrition on hepatobiliary imaging with technetium-99m DISIDA.Clin Nucl Med 12:169–172, 1987
Freitas JE: Cholescintigraphy in acute and chronic cholecystitis.Sem Nucl Med 12:18–26, 1982
Pare P, Shaffer EA, Rosenthal L: Nonvisualization of the gallbladder by Tc-99m-HIDA cholescintigraphy as evidence of cholecystitis.Can Med Assoc J 118:384–386, 1978
Weissmann HS, Riley DC, Badia J, Miller L, Freeman LM: Significance of delayed gallbladder visualization in Tc-99m-IDA cholescintigraphy.RSNA, Abstract 167, 1985
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Klingensmith, W.C., Turner, W.M. Cholescintigraphy for acute cholecystitis: False positive results caused by chronic cholecystitis. Gastrointest Radiol 15, 129–132 (1990). https://doi.org/10.1007/BF01888755
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DOI: https://doi.org/10.1007/BF01888755