Results of cholescintigraphy in a VA hospital.
In a review of 200 hepatobiliary imaging studies done in a VA hospital over a 5-year period, a sensitivity of 96% and a specificity of 88% were obtained. In a subgroup of 40 patients with alcoholic liver disease, the specificity dropped to 60% although the sensitivity remained high (100%). These data indicated that in patients with alcoholic liver disease a positive DISIDA scan is not diagnostic of acute cholecystitis and cannot be interpreted as an indication for cholecystectomy. Possible modifications of imaging techniques, including delayed imaging and morphine-augmented cholescintigraphy, may prove to increase the specificity of cholescintigraphy in these patients. A prospective study using these modifications would help in determining the current role of cholescintigraphy in the diagnosis of acute cholecystitis in patients with alcoholic liver disease.
Carballo
R
R
Surgical Service and Nuclear Medicine Service, Hines VA Hospital, Illinois.
Worsch
L
L
Bushnell
D
D
Aranha
G V
GV
D002764:Cholecystitis / Q000000981:diagnostic imaging*; D002769:Cholelithiasis / Q000000981:diagnostic imaging*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005704:Gallbladder / Q000000981:diagnostic imaging; D006787:Hospitals, Veterans; D006801:Humans; D007087:Illinois; D008104:Liver Cirrhosis, Alcoholic / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012189:Retrospective Studies