^99mTc-IDA Imaging in the Differential Diagnosis of Acute Cholecystitis and Acute Pancreatitis

Abstract

99mTc-IDA (99mTc-dimethyl-acetanilide-iminodiacetic acid) hepato-biliary imaging was evaluated for its efficacy in distinguishing acute cholecystitis from acute pancreatitis. In a retrospective review, gallbladders were demonstrated by 99mTc-IDA in 13 of 15 patients (87%) with acute pancreatitis. This is significantly higher than reports on the frequency of gallbladder filling with oral and intravenous cholangiography in the presence of acute cholecystitis.

Diagnosis of acute pancreatitis using the amylase‐creatinine clearance ratio and radionuclide hepatobiliary and pancreas imaging

“…Visualization of gallbladder filling with 99mTc-HIDA helped to reach the diagnosis of acute pancreatitis in 13 of 15 patients studied by Fonseca et al [22]. In their study, both patients whose gallbladder did not fill had coincident chronic cholecystitis.…”

“…This is important since a normal gallbladder fails to be visualized by oral cholecystography or intravenous cholangiography in 25-60% of patients during or immediately after acute pancreatitis [24,25]. Other advantages of RHBI are its ability to demonstrate patency of the cystic duct, even in the presence of jaundice; gas and feces do not interfere with the image; there are no untoward reactions to the radiopharmaceutical; and in most cases, the test is completed within 1 hour [8,22]. In addition, liver disease can be demonstrated during the study.…”