Scintigraphic findings in acute gangrenous cholecystitis.
Nine patients who had surgically proven acute gangrenous cholecystitis and Tc-99m DISIDA scintigrams were reviewed retrospectively. Three types of scintigraphic findings were presented: 1) nonvisualization of the gallbladder, three cases; 2) nonvisualization of the gallbladder plus a rim sign, two cases; and 3) nonvisualization of the gallbladder plus an enlarged photon deficient area corresponding to the gallbladder fossa, four cases. A rim sign or an enlarged gallbladder fossa reflect the direct spread of inflammation from the gallbladder into the liver, causing impaired hepatocyte function. An enlarged gallbladder fossa may represent a later stage of a rim sign. Presumably tracer excretion by hepatocytes is affected initially by the inflammatory process, followed by impairment of tracer concentrating ability. Since the gallbladder may be suspended occasionally by a mesentery and not in contact with the liver, the secondary signs may be absent in acute gangrenous cholecystitis.
Shih
W J
WJ
Nuclear Medicine Service, Veterans Administration Medical Center, Lexington, Kentucky.
Domstad
P A
PA
Kenady
D E
DE
DeLand
F H
FH
D000208:Acute Disease; D000368:Aged; D002764:Cholecystitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D005734:Gangrene; D006801:Humans; D007098:Imino Acids; D008107:Liver Diseases / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D019785:Technetium Tc 99m Disofenin
D007098:Imino Acids; D009942:Organometallic Compounds; D019785:Technetium Tc 99m Disofenin