The role of 99mTc mebrofenin hepatobiliary scanning in predicting common bile duct stones in patients with gallstone disease.
BACKGROUND
A dilated common bile duct and/or elevated serum alkaline phosphatase, raises a suspicion of bile duct stone(s) in patients with gallstones. Cholangiography, either endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP), is the best method for diagnosing bile duct stones. ERCP has the disadvantage of being invasive, and there is a risk of complications; while MRCP is costly and is not widely available.


OBJECTIVE
The objective of the present study was to evaluate the role of hepatobiliary nuclear scanning in diagnosing bile duct stones.


METHODS
Twenty-five patients with suspected common bile duct (CBD) stones underwent hepatobiliary scintigraphy. The results of scintigraphy were compared with cholangiograms obtained by ERCP in 11 patients and MRCP in 14 patients, considering MRCP/ERCP as the 'gold standard'.


RESULTS
Scintigraphy showed features suggestive of CBD stones in 11 of the 25 patients. The results of ERCP/MRCP confirmed that eight of them had stones. Scintigraphy showed no features of CBD stones in the remaining 14 patients. ERCP/MRCP showed CBD stones in two of these 14 patients. Thus, scintigraphy had a sensitivity of 80% and a specificity of 80%.


CONCLUSIONS
We conclude that scintigraphy has good sensitivity and specificity in predicting CBD stones in patients with gallstone disease and a dilated CBD.
Iqbal
Mohammed
M
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
Aggarwal
Sandeep
S
Kumar
Rakesh
R
Garg
Pramod Kumar
PK
Bandhu
Suman
S
Kumar
Arvind
A
Parshad
Rajinder
R
Guleria
Sandeep
S
D000328:Adult; D000368:Aged; D000814:Aniline Compounds; D001659:Biliary Tract / Q000000981:diagnostic imaging; D002758:Cholangiography; D042883:Choledocholithiasis / Q000150:complications / Q000000981:diagnostic imaging*; D003135:Common Bile Duct / Q000000981:diagnostic imaging* / Q000473:pathology*; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D042882:Gallstones / Q000150:complications / Q000000981:diagnostic imaging*; D005998:Glycine; D006801:Humans; D007098:Imino Acids; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D000814:Aniline Compounds; D007098:Imino Acids; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C034837:technetium Tc 99m mebrofenin; D005998:Glycine