Quantitative cholescintigraphy with fatty meal in the diagnosis of Sphincter of Oddi dysfunction and acalculous cholecystopathy

被引：7
作者：
Sampath Santhosh
Bhagwant Rai Mittal
Sasikumar Arun
Ashwani Sood
Anish Bhattacharya
Rakesh Kochhar
机构：
[1] Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research
[2] Department of Gastroenterology, Postgraduate Institute of Medical Education and Research
来源：
Indian Journal of Gastroenterology | 2012年 / 31卷 / 4期
关键词：
Biliary dyskinesia; Fatty meal; HIDA; SOD; Sostre score;
D O I：
10.1007/s12664-012-0241-x
中图分类号：
学科分类号：
摘要：
To evaluate the role of quantitative cholescintigraphy with fatty meal in the management of biliary dyskinesia and to describe the findings according to Sostre score (SS) criteria in patients with gallbladder (GB) in-situ and biliary pain. We performed a retrospective analysis of the hepatobiliary (HIDA) studies (n = 35) performed for evaluation of biliary dyskinesia either due to biliary pain, opioid induced sphincter of Oddi dysfunction (SOD), recurrent pancreatitis (RP) or post cholecystectomy syndrome (PCS). Gallbladder ejection fraction (GBEF) was calculated from the post fatty meal HIDA images (excluding PCS patients). Studies with GBEF ≤40 % and SS >4 were considered to have cholecystopathy and SOD respectively. Three of the 13 patients with PCS had SS of 6 each, suggestive of SOD. Delayed biliary visualization (>15 min) and activity in common bile duct 60 min > liver15 min were the specific features in these cases. Opioid induced SOD patients had SS >4 with retrograde refilling of GB in one patient and normalization of the SS parameters after nifedipine challenge in the other patient. Patients with RP and biliary pain were stratified into four groups, normal (GBEF >40 % and SS ≤4), cholecystopathy (GBEF ≤40 % and SS ≤4), normal with SOD (GBEF >40 % and SS >4) and cholecystopathy with SOD (GBEF ≤40 % and SS >4). Four patients with intact GB had cholecystopathy with scintigraphic features of SOD. Quantitative cholescintigraphy with fatty meal and SS scoring identified biliary dyskinesia and SOD in patients with biliary pain, recurrent pancreatitis and post-cholecystectomy syndrome. © 2012 Indian Society of Gastroenterology.
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页码：186 / 190
页数：4
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