Chronic cholecystitis other imaging findings: Difference between revisions

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'''Diagnosis:''' RC alone or RC and MC.
'''Diagnosis:''' RC alone or RC and MC.


[[File:Chronic-acalculous-cholecystitis (1).jpg|400px|thumb|center|HIDA scan for '''chronic acalculous cholecysstitis''' <small> Case courtesy of Dr Matthew Lukies, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/46881">rID: 46881</a><ref name="urlChronic cholecystitis | Radiology Reference Article | Radiopaedia.org">{{cite web |url=https://radiopaedia.org/articles/chronic-cholecystitis |title=Chronic cholecystitis &#124; Radiology Reference Article &#124; Radiopaedia.org |format= |work= |accessdate=}}</ref></small>]]
[[File:Chronic-acalculous-cholecystitis (1).jpg|400px|thumb|center|HIDA scan for '''chronic acalculous cholecysstitis''' showing delayed gallbladder visualization. <small> Case courtesy of Dr Matthew Lukies, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/46881">rID: 46881</a><ref name="urlChronic cholecystitis | Radiology Reference Article | Radiopaedia.org">{{cite web |url=https://radiopaedia.org/articles/chronic-cholecystitis |title=Chronic cholecystitis &#124; Radiology Reference Article &#124; Radiopaedia.org |format= |work= |accessdate=}}</ref></small>]]
Chronic-acalculous-cholecystitis.jpg


==References==
==References==

Revision as of 15:34, 8 February 2018

Chronic cholecystitis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2], Furqan M M. M.B.B.S[3]

Other Imaging Findings

Cholescintigraphy

HIDA cholescintigraphy findings for chronic cholecystitis include delayed gallbladder isotope accumulation, irregular gallbladder filling, or photopenic areas and septations. A gallbladder ejection fraction of less than 35% after the administration of cholecystokinin indicates the presence of the chronic calculus or chronic acalculous cholecystitis.

  • Hepatobiliary scintigraphy with technetium-99m is also sensitive and accurate for diagnosis of chronic cholecystitis. It can also assess the ability of the gallbladder to expel bile (gallbladder ejection fraction), and a low gallbladder ejection fraction has been linked to chronic cholecystitis. However, since most patients with right upper quadrant pain do not have cholecystitis, primary evaluation is usually accomplished with a modality that can diagnose other causes as well. [1] [2]
  • Signs of chronic cholecystitis on HIDA cholescintigraphy include delayed gallbladder isotope accumulation, irregular gallbladder filling, and septations. A gallbladder ejection fraction of less than 35% after the administration of cholecystokinin indicates the presence of chronic calculus or chronic acalculous cholecystitis.[3]

Acalculous Cholecystitis

The HIDA cholescintigraphy based diagnostic criteria from multiple studies for acalculous cholecystits is as follows.[4]

Criteria Diagnosis
RC
MC
Nonvisualization of the gallbladder 1 hour after injection of radiolabeled technetium ([this is radionuclide cholescintigraphy (RC)]
Nonvisualization of the gallbladder 30 minutes after injection of morphine (after initial radiolabeled technetium) [this is morphine cholescintigraphy (MC)]

Diagnosis: RC alone or RC and MC.

HIDA scan for chronic acalculous cholecysstitis showing delayed gallbladder visualization. Case courtesy of Dr Matthew Lukies, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/46881">rID: 46881</a>[5]

References

  1. Shea, JA, Berlin, JA, Escarce, JJ, et al. Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease. Arch Intern Med 1994; 154:2573.
  2. Fink-Bennett, D, Freitas, JE, Ripley, SD, Bree, RL. The sensitivity of hepatobiliary imaging and real time ultrasonography in the detection of acute cholecystitis. Arch Surg 1985; 120:904.
  3. Chamarthy, M.; Freeman, LM. (2010). "Hepatobiliary scan findings in chronic cholecystitis". Clin Nucl Med. 35 (4): 244–51. doi:10.1097/RLU.0b013e3181d18ef5. PMID 20305411. Unknown parameter |month= ignored (help)
  4. Huffman, JL.; Schenker, S. (2010). "Acute acalculous cholecystitis: a review". Clin Gastroenterol Hepatol. 8 (1): 15–22. doi:10.1016/j.cgh.2009.08.034. PMID 19747982. Unknown parameter |month= ignored (help)
  5. "Chronic cholecystitis | Radiology Reference Article | Radiopaedia.org".


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