Chronic cholecystitis other diagnostic studies: Difference between revisions
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==Overview== | ==Overview== | ||
Hepatobiliary [[nuclear medicine|scintigraphy]] with [[technetium]]-99m DISIDA ([[bilirubin]]) analog is also sensitive and accurate for diagnosis of chronic and acute cholecystitis. It can also assess the ability of the gallbladder to expel bile (gallbladder ejection fraction), and a low gallbladder ejection fraction has been linked to chronic cholecystitis. However, since most patients with right upper quadrant pain do not have cholecystitis, primary evaluation is usually accomplished with a modality that can diagnose other causes as well. <ref name="Shea">Shea, JA, Berlin, JA, Escarce, JJ, et al. ''Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease''. Arch Intern Med 1994; 154:2573.</ref> <ref name="Fink">Fink-Bennett, D, Freitas, JE, Ripley, SD, Bree, RL. ''The sensitivity of hepatobiliary imaging and real time ultrasonography in the detection of acute cholecystitis''. Arch Surg 1985; 120:904.</ref> | Hepatobiliary [[nuclear medicine|scintigraphy]] with [[technetium]]-99m DISIDA ([[bilirubin]]) analog is also sensitive and accurate for diagnosis of chronic and acute cholecystitis. It can also assess the ability of the gallbladder to expel bile (gallbladder ejection fraction), and a low gallbladder ejection fraction has been linked to chronic cholecystitis. However, since most patients with right upper quadrant pain do not have cholecystitis, primary evaluation is usually accomplished with a modality that can diagnose other causes as well. <ref name="Shea">Shea, JA, Berlin, JA, Escarce, JJ, et al. ''Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease''. Arch Intern Med 1994; 154:2573.</ref> <ref name="Fink">Fink-Bennett, D, Freitas, JE, Ripley, SD, Bree, RL. ''The sensitivity of hepatobiliary imaging and real time ultrasonography in the detection of acute cholecystitis''. Arch Surg 1985; 120:904.</ref> | ||
===Imaging Criteria for Acalculous Cholecystitis=== | |||
The HIDA scan based diagnostic criteria from multiple studies for acalculous cholecystits is as follows.<ref name="Huffman-2010">{{Cite journal | last1 = Huffman | first1 = JL. | last2 = Schenker | first2 = S. | title = Acute acalculous cholecystitis: a review. | journal = Clin Gastroenterol Hepatol | volume = 8 | issue = 1 | pages = 15-22 | month = Jan | year = 2010 | doi = 10.1016/j.cgh.2009.08.034 | PMID = 19747982 }}</ref> | |||
{|class="wikitable" | |||
! Criteria!! Diagnosis | |||
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| RC<BR>MC || Nonvisualization of the gallbladder 1 hour after injection of radiolabeled technetium ([this is radionuclide cholescintigraphy (RC)]<br>Nonvisualization of the gallbladder 30 minutes after injection of morphine (after initial radiolabeled technetium) [this is morphine cholescintigraphy (MC)] | |||
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'''Diagnosis:''' RC alone or RC and MC. | |||
==References== | ==References== |
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Overview
Hepatobiliary scintigraphy with technetium-99m DISIDA (bilirubin) analog is also sensitive and accurate for diagnosis of chronic and acute cholecystitis. It can also assess the ability of the gallbladder to expel bile (gallbladder ejection fraction), and a low gallbladder ejection fraction has been linked to chronic cholecystitis. However, since most patients with right upper quadrant pain do not have cholecystitis, primary evaluation is usually accomplished with a modality that can diagnose other causes as well. [1] [2]
Imaging Criteria for Acalculous Cholecystitis
The HIDA scan based diagnostic criteria from multiple studies for acalculous cholecystits is as follows.[3]
Criteria | Diagnosis |
---|---|
RC MC |
Nonvisualization of the gallbladder 1 hour after injection of radiolabeled technetium ([this is radionuclide cholescintigraphy (RC)] Nonvisualization of the gallbladder 30 minutes after injection of morphine (after initial radiolabeled technetium) [this is morphine cholescintigraphy (MC)] |
Diagnosis: RC alone or RC and MC.
References
- ↑ Shea, JA, Berlin, JA, Escarce, JJ, et al. Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease. Arch Intern Med 1994; 154:2573.
- ↑ Fink-Bennett, D, Freitas, JE, Ripley, SD, Bree, RL. The sensitivity of hepatobiliary imaging and real time ultrasonography in the detection of acute cholecystitis. Arch Surg 1985; 120:904.
- ↑ Huffman, JL.; Schenker, S. (2010). "Acute acalculous cholecystitis: a review". Clin Gastroenterol Hepatol. 8 (1): 15–22. doi:10.1016/j.cgh.2009.08.034. PMID 19747982. Unknown parameter
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ignored (help)