Biliary scintigraphy in acute pancreatitis.

Serafini, A N; Al-Sheikh, W.; Barkin, Jamie S.; Hourani, Mukbil; Sfakiankis, G; Clarke, LP; Ashkar, F S

doi:10.1148/radiology.144.3.7100478

Cited by 16 publications

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“…Yet obstructive cholecystitis cannot explain the lack ofGB visualization in 2 patients (12.5%) with non-gallstone pancreatitis, in whom gallstones were excluded on the basis of laparotomy and post-mortem findings, respectively. This phenomenon has been re ported previously [20,21] and its aetiology is unknown.…”

Section: Discussionmentioning

confidence: 69%

“…However, the scanning time in these stud ies has varied between 1 h [22] and 6 h [20] with a posi tive test being defined as an absent GB image. Serafini et al [21], in a study of 60 patients with acute pancreatitis, recorded images up to 24 h and classified scans into 5 groups on the basis of the rate of uptake of isotope by the GB and its excretion into the duodenum. 78% of patients with gallstone pancreatitis had an abnormal scan.…”

Section: Discussionmentioning

confidence: 99%

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Radionuclide Biliary Scanning in the Diagnosis of Gallstone Pancreatitis

Downing¹,

Timmins²,

Watkins³

et al. 1985

Dig Surg

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The ability of hepatobiliary scanning (^99mTc HID A) to distinguish gallstone (GS) from non-gallstone (NGS) pancreatitis was investigated in 29 patients. 4 patients had repeat scans during a recurrent attack (33 scans in 29 patients). 15 patients (17 scans) had GS – in 13 scans the gallbladder was not visualized (sensitivity = 76.5%) compared to 2 of the 16 scans in patients with NGS (specificity = 87.5%). The duodenum was not visualized in 2 (11.8%) and 4 (25%) scans in the GS and NGS groups, respectively. Isotope appeared in the duodenum at 25.7 ± 9.2 min (mean ± SD) in the GS group and 33.3 ± 10.5 in the NSG group (p < 0.02). Hepatobiliary scanning provides a dynamic study of bile excretion in acute pancreatitis, but cannot be used alone to confidently diagnose the presence of gallstones.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Radionuclide Biliary Scanning in the Diagnosis of Gallstone Pancreatitis

Downing¹,

Timmins²,

Watkins³

et al. 1985

Dig Surg

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The urgent diagnosis of gallstones in acute pancreatitis: A prospective study of three methods

Neoptolemos

Hall

Finlay

et al. 1984

Journal of British Surgery

114

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Ultrasonography (US), radionuclide biliary scanning (RBS), and biochemical tests were performed within 72 h of admission in 83 patients with acute pancreatitis in an attempt to define those with gallstones as an aetiological factor. US was 92 per cent accurate in the 80 per cent of patients in whom the gallbladder was demonstrated. There were no false positives. Sixty-seven per cent of patients with gallstones were diagnosed although this improved to 78 per cent when US was repeated following the patients' clinical improvement. The pattern of RBS was completely normal in 46.5 per cent of patients with biliary pancreatitis and 64 per cent of patients with non-biliary pancreatitis. Biochemical tests completely separated 47 per cent of patients with gallstones from those without. Used in combination with US these two methods accurately identified 81 per cent of patients in the biliary group. In conclusion US was found to be a rapid and accurate method of gallstone detection but used alone it has limited usefulness. RBS can be time consuming and was found to be of doubtful value. Biochemical tests were helpful in indicating a proportion of patients who had gallstones which were not detected by US, and therefore have a practical application. Current methods of gallstone detection in patients with acute pancreatitis are far from ideal and further studies are indicated.

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Technetium-99m-iminodiacetic acid organic anions: Review of biokinetics and clinical application in hepatology

Krishnamurthy

1989

Hepatology

104

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Technetium-99m-labeled iminodiacetic acid analogs are a new class of organic anions, taken up and secreted by hepatocyte into hepatic bile by a carrier-mediated organic anion pathway. They provide a new dimension in the assessment of pathophysiology and morphology of the hepatobiliary system. The amount of uptake and the rapidity of its elimination from the liver is dependent upon the structural configuration of the agent as well as the functional integrity of the hepatocyte and the patency of the biliary system. The clinical areas for application are wide and include most of the hepatobiliary diseases. Technetium-99m-iminodiacetic acid, an agent well suited for both planar and single photon tomographic scintigraphy, is ideal for early diagnosis prior to anatomical changes in the hepatobiliary system. The data collection directly from the liver provides quantitation of both regional and global liver diseases. The count-based method for measuring gallbladder emptying overcomes the theoretical disadvantages of geometric tests. Biokinetics and current clinical application of six of the 99mTc-iminodiacetic acid agents are reviewed, and the potential future clinical and research areas of application are indicated.

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Biliary scintigraphy in acute pancreatitis.

Cited by 16 publications

References 0 publications

Radionuclide Biliary Scanning in the Diagnosis of Gallstone Pancreatitis

Radionuclide Biliary Scanning in the Diagnosis of Gallstone Pancreatitis

The urgent diagnosis of gallstones in acute pancreatitis: A prospective study of three methods

Technetium-99m-iminodiacetic acid organic anions: Review of biokinetics and clinical application in hepatology

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