The value of sonography in determining cystic duct patency.
A prospective blinded comparison of ultrasonography (US) and oral cholecystography (OCG) was performed in 100 patients with symptomatic gall-stones to determine whether US would enable an accurate assessment of cystic duct patency to be made. Patency of the cystic duct was defined as gall-bladder opacification on OCG or a greater than 20% decrease in gall-bladder volume by US post-fatty meal. The ellipsoid method of volume measurement was used. Any patient who had a non-opacified gall-bladder on OCG but a greater than 20% volume decrease on US had cholescintigraphy performed (DISIDA). Oral cholecystography demonstrated cystic duct patency in 88 patients (88%), and fatty-meal gall-bladder US met the specified study criteria for patency in 86 patients (86%). False negative results were identified in four of the OCG and in six of the US examinations. The results of this study indicate that gall-bladder sonography with a post-fatty meal contraction of greater than 20% is a very accurate predictor of cystic duct patency. A contraction of less than 20%, however, cannot be considered a reliable predictor of cystic duct occlusion.
McGrath
F P
FP
Department of Radiology, University of British Columbia, Vancouver, Canada.
Gibney
R G
RG
Burhenne
H J
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002765:Cholecystography; D002769:Cholelithiasis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002779:Cholestasis / Q000000981:diagnostic imaging; D003549:Cystic Duct / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D014463:Ultrasonography