A Large and Distinct Gallbladder Fossa in a 60-miunte Image of Hepatobiliary Scintigraphy: Correlation with CT, ERCP, and Autopsy Findings

核醫肝膽造影異常膽囊窩影像與電腦斷層、內視鏡逆行性膽胰攝影及病理解剖之比較

樊裕明(Yu-Ming Fan) ； 施兆昌(George Shih) ； 施维貞(Wei-Jen Shih) ； Primo P. Milan ； 黃文盛(Wen-Sheng Huang)

《核子醫學雜誌》 17卷4期 (2004/12) Pp. 229-232

https://doi.org/10.6332/ANMS.1704.008

摘要

一位嚴重黃膽且做過內視鏡逆行性膽管胰臟攝影術之病患，在接受核子醫學肝膽造影術60分鐘時出現顯著肝臟放射活性，膽囊窩則有一大且明顯的放射活性缺損，但在膽囊、膽管和腸道皆無放射活性攝取。除此之外，亦發現心臟擴大所產生的血池放射活性，兩側腎臟的放射活性及腹水現象，這些現象與電腦斷層及內視鏡逆行性膽管胰臟攝影術的發現：如總膽管結石、膽囊結石、腹水、肝功能異常和心臟衰竭等一致。在日後的解剖中進而證實此病患有腹水、膽囊結石、C型肝炎造成的肝硬化、心臟擴大所伴隨的嚴重冠狀動脈疾病和心肌梗塞的形成。

關鍵字

肝膽造影術 ； 膽囊窩 ； 內視鏡逆行性膽管胰臓攝影術

並列摘要

An image at 60 min of hepatobiliary scintigraphy in a patient with severe jaundice and post endoscopic retrograde cholangiopancreatogray (ERCP) illustrated prominent activity in the liver with a large and distinctive defect in the gallbladder fossa, no activity in the gallbladder, biliary duct and bowel. In addition, blood pool activity in the enlarged heart and renal activity of both kidneys and sign of ascites were also seen. These findings correlated with CT and ERCP radiographic findings showing common bile duct stones, gallbladder stones, and ascites. Dysfunction of the liver and heart failure also contributed to these findings. At autopsy, ascites, gallstones, evidence of cirrhosis of the liver secondary to hepatitis C infection, and cardiomegaly with severe coronary artery disease and myocardial infarction were confirmed.

並列關鍵字

cholescintigraphy ； gallbladder fossa ； endoscopic retrograde cholangiopancreatography (ERCP)