Morphine-augmented cholescintigraphy: its efficacy in detecting acute cholecystitis.
Cholescintigrams were performed in 158 patients suspected of having acute cholecystitis after administration of 185 Mbq (5 mCi) of 99mTc-mebrofenin or disofenin. Morphine sulfate, 0.04 mg/kg was given intravenously if there was nonvisualization of the gallbladder at 40-60 min provided that radiotracer was seen within the small bowel. Acute cholecystitis was deemed present if there was nonvisualization of the gallbladder 30 min post-morphine administration; no cystic duct obstruction was present if the gallbladder was demonstrated pre- or post-morphine administration. A final diagnosis was estimated in 51 postoperative patients histologically, the remainder having their final diagnosis gleaned from their medical records. The sensitivity, specificity, positive and negative predictive value of morphine-augmented cholescintigraphy in detecting acute cholecystitis was 94.6, 99.1, 97.2, and 98.3%, respectively. These findings indicate that morphine-augmented cholescintigraphy detects acute cholecystitis with as high a degree of accuracy as conventional hepatobiliary scintigraphy, yet requires only 1.5 hr to establish the diagnosis.
Fink-Bennett
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Department of Nuclear Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073.
Balon
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H
Robbins
T
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Tsai
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D
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000814:Aniline Compounds; D002764:Cholecystitis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D005998:Glycine; D006801:Humans; D007098:Imino Acids; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D019785:Technetium Tc 99m Disofenin
D000814:Aniline Compounds; D007098:Imino Acids; D015609:Organotechnetium Compounds; D009020:Morphine; C034837:technetium Tc 99m mebrofenin; D019785:Technetium Tc 99m Disofenin; D005998:Glycine