Radionuclide angiography in suspected acute cholecystitis: further observations.
Radionuclide angiography (RNA) and cholescintigraphy were performed prospectively in 300 patients with suspected acute cholecystitis (AC). Of 79 patients with positive RNA, 63 had AC (80%). Positive RNA was seen in 23 of 26 cases with gangrenous AC (88%) while 12 of the 26 had a positive "rim" sign (46%). All 12 patients with a positive "rim" sign had positive RNA. The "rim" sign may be caused by increased perfusion. Five of 6 patients with positive RNA and "obstructive" pattern had AC (83%). Patients with negative RNA and positive cholescintigraphy had a positive predictive value of 54% (31/57), while those with positive RNA and positive cholescintigraphy had a positive predictive value of 85% (57/67). RNA showed increased perfusion to nonbiliary pathology such as liver abscesses and pyelonephritis. Positive RNA increases the predictive value of cholescintigraphy and may be useful to shorten cholescintigraphic examinations.
Colletti
P M
PM
University of Southern California, School of Medicine, Department of Radiology, Los Angeles.
Cirimelli
K M
KM
Radin
D R
DR
Chandrasoma
P
P
Ralls
P W
PW
Siegel
M E
ME
D000328:Adult; D002764:Cholecystitis / Q000000981:diagnostic imaging*; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011875:Radionuclide Angiography