title: A diagnostic dilemma of atypical gallbladder appearance on Tc-99m HIDA cholescintigraphy resolved with SPECT/CT.
abstract: Tc-99m HIDA cholescintigraphy is the diagnostic procedure of choice for acute cholecystitis. Acute cholecystitis is associated in vast majority of the cases with cystic duct obstruction. The demonstration of presence (cystic duct patency) or absence (cystic duct obstruction) of visualization of the gallbladder on cholescintigraphy is critical to the diagnosis of acute cholecystitis. The visualization of the gallbladder rules out acute cholecystitis in most of the cases. Although, in most cases, determination of visualization or nonvisualization of gallbladder is straight forward, occasionally it can be challenging. We describe a patient with suspected acute cholecystitis, in whom an unusual appearance of the gallbladder on hepatobiliary scintigraphy was clarified with SPECT/CT, an approach that is rarely used in Tc-99m HIDA cholescintigraphy.
authors.affiliation: Department of Nuclear Medicine, UIOWA Hospitals and Clinics, Iowa City, IA, USA. rsood@sbcglobal.net
authors.forename: Ravi
authors.initials: R
authors.lastname: Sood
authors.forename: Jeff
authors.initials: J
authors.lastname: Murguia
authors.forename: Michael M
authors.initials: MM
authors.lastname: Graham
authors.forename: David
authors.initials: D
authors.lastname: Bushnell
authors.forename: Shayne
authors.initials: S
authors.lastname: Squires
authors.forename: Sandeep T
authors.initials: ST
authors.lastname: Laroia
authors.forename: Anish
authors.initials: A
authors.lastname: Bansal
mesh_terms: D000368:Aged; D002764:Cholecystitis / Q000000981:diagnostic imaging; D002765:Cholecystography / Q000379:methods*; D005704:Gallbladder / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D019780:Technetium Tc 99m Lidofenin; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D019780:Technetium Tc 99m Lidofenin