核醫膽道造影在急性胰臟炎患者之應用

Tc-99m Cholescintigraphy in Acute Pancreatitis

許忠源(Chung-Yuan Hsu) ； 廖澍昆(Su-Quinn Liao) ； 高嘉鴻(Chia-Hung Kao) ； 林萬鈺(Wan-Yu Lin) ； 王世楨(Shyh-Jen Wan)

《The Kaohsiung Journal of Medical Sciences》 10卷3期 (1994/03) Pp. 152-156

https://doi.org/10.6452/KJMS.199403.0152

摘要

Tc-99m DISIDA cholescintigraphy is a highly sensitive and specific method of evaluating cystic duct obstruction in acute cholecystitis. It has also been argued that cholescintigraphy has high sensitivity in the differential diagnosis of gallstone pancreatitis due to cystic duct obstruction following gallstone migration.
The purpose of this study was to evaluate the clinical availability of cholescintigraphy in acute pancreatitis. Tc-99m DISIDA cholescintigraphy performed in 18 patients with documented acute pancreatitis, including 11 gallstone and 7 nonbiliary, were reviewed. Abnormal scans were obtained in 82% (9/11) of acute gallstone pancreatitis, while only 29% (2/7) of acute nonbiliary pancreatitis had abnormal scan. These results demonstrated a significant difference with Fisher¡¦s exact test (p＜0.05). An abnormal cholescintigraphy had a sensitivity of 82%, a specificity of 71% and an accuracy of 78% in detecting gallstone pancreatitis. Ten cases of acute gallstone pancreatitis coincided with cholecystitis (2 cases of acute and chronic, and 8 cases of chronic). Both cases of acute nonbiliary pancreatitis with abnormal scan had total parenteral nutrition over 5 days.
In conclusion, abnormal cholescintigraphy in acute pancreatitis indicates gallstone origin and may coincide with cholecystitis; while, a normal cholescintigraphy largely excludes such diagnoses.

並列摘要

Tc-99m DISIDA cholescintigraphy is a highly sensitive and specific method of evaluating cystic duct obstruction in acute cholecystitis. It has also been argued that cholescintigraphy has high sensitivity in the differential diagnosis of gallstone pancreatitis due to cystic duct obstruction following gallstone migration.
The purpose of this study was to evaluate the clinical availability of cholescintigraphy in acute pancreatitis. Tc-99m DISIDA cholescintigraphy performed in 18 patients with documented acute pancreatitis, including 11 gallstone and 7 nonbiliary, were reviewed. Abnormal scans were obtained in 82% (9/11) of acute gallstone pancreatitis, while only 29% (2/7) of acute nonbiliary pancreatitis had abnormal scan. These results demonstrated a significant difference with Fisher¡¦s exact test (p＜0.05). An abnormal cholescintigraphy had a sensitivity of 82%, a specificity of 71% and an accuracy of 78% in detecting gallstone pancreatitis. Ten cases of acute gallstone pancreatitis coincided with cholecystitis (2 cases of acute and chronic, and 8 cases of chronic). Both cases of acute nonbiliary pancreatitis with abnormal scan had total parenteral nutrition over 5 days.
In conclusion, abnormal cholescintigraphy in acute pancreatitis indicates gallstone origin and may coincide with cholecystitis; while, a normal cholescintigraphy largely excludes such diagnoses.

並列關鍵字

Pancreatitis ； gallstonc ； cholescintigraphy