SCINTIGRAPHIC DETECTION OF COMMON BILE DUCT (CBO) OBSTRUCTION: A CHOLANGIOGRAPHIC CORRELATION

• Published in: Clinical nuclear medicine 1984-09, Vol.9 (9S Suppl), p.43-43
• Main Authors: Krishnamurthy, G T, Lieberman, David A, Brar, Harindar S
• Format: Article
• Language: English
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/00003072-198409001-00053

The purpose of the study was to critically assess the role of Tc-99m-IDA scintigraphy in 25 patients with either partial (n=14) or complete (n=11) CBD obstruction and to correlate results with the cholangiogram. After a minimum 4 hour fast, each patient received 3 to 8 mCi of Tc-99m-IDA intravenously and the serial hepatobiliary images were obtained at 2 minute intervals for 60 minutes and at 3 and 24 hours when needed. Nine patients with partial CBO obstruction received OP-CCK for quantitative assessment of biliary dynamics.Scintigraphically, the partial CBD obstruction was characterized by either segmental narrowing or intraluminal filling defect (13/14), intrahepatic bile pooling in area and segmental ducts (7/14) and markedly reduced gallbladder ejection fraction (8/9) and ejection rate (6/9). The obstruction was distal in 8, mid to distal in 5 and the level of obstruction correlated well with Rholangiogram. Complete CBD obstruction was characterized by relatively good hepatic uptake but no secretion into bile of Tc-99m-IDA resulting in total non-visualization of entire biliary system (including GB and CBD) and small intestine in 10 of 11 patients. CBD was faintly seen in one patient. Localization could not be made in any with complete CBD obstruction.It is concluded that Tc-99m-IDA scintigraphy is an accurate test for detection of CBD obstruction and localization can be accomplished in partial but not total CBD obstruction. Thus scintigraphy may service as an ideal non-invasive screening test in assessing CBD obstruction.