title: Morphine-augmented cholescintigraphy in acute cholecystitis. A satisfactory alternative to delayed imaging.
abstract: The utility of morphine-augmented cholescintigraphy was reviewed in 32 patients with suspected acute cholecystitis. All patients were administered 2 mg morphine sulfate intravenously when the gallbladder failed to visualize 30 minutes into the study, and imaging continued for up to 60 minutes. Sensitivity for detection of acute cholecystitis was 93% (13 out of 14). Specificity was 78% (14 out of 18). Three of four false-positives occurred in the setting of prolonged fasting and chronic cholecystitis. Cumulative experience suggests that the technique is diagnostically equivalent to imaging for up to 4 hours and that specificity remains incomplete in the setting of prolonged fasting, chronic cholecystitis and other conditions known to affect conventional cholescintigraphy.
authors.affiliation: Division of Nuclear Medicine, National Naval Medical Center, Bethesda, Maryland 20814.
authors.forename: A M
authors.initials: AM
authors.lastname: Kistler
authors.forename: H A
authors.initials: HA
authors.lastname: Ziessman
authors.forename: D
authors.initials: D
authors.lastname: Gooch
authors.forename: P
authors.initials: P
authors.lastname: Bitterman
mesh_terms: D000208:Acute Disease; D000814:Aniline Compounds; D002764:Cholecystitis / Q000000981:diagnostic imaging*; D005215:Fasting; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging*; D005998:Glycine; D006801:Humans; D007098:Imino Acids; D008297:Male; D008875:Middle Aged; D009020:Morphine; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D000814:Aniline Compounds; D007098:Imino Acids; D015609:Organotechnetium Compounds; D009020:Morphine; C034837:technetium Tc 99m mebrofenin; D005998:Glycine