Scintigraphy of the gallbladder and bile ducts with derivatives of iminodiacetic acid (HIDA). Diagnostic utility

Abstract

The findings in 24 cases referred to with the diagnosis of acute cholecystitis are analyzed together with the surgical and pathological reports of the gallbladder. The results at HIDA were compatible with acute cholecystitis in 21 cases.

Pathology showed acute and chronic cholecystitis in 7 cases, acute cholecystitis in 3 cases, and chronic cholecystitis in 10 cases. One case was normal (representing a false positive). Fifteen of these patients also had gallstones associated with acute or chronic cholecystitis. In six cases without cholelithiasis but with a positive HIDA (nonvisualization of the gallbladder), pathology showed acute cholecystitis without stones in 3 cases: 2 with pyocholecyst and 1 with hydrocholecyst. The usefulness of HIDA was analyzed in terms of its role in evaluating the permeability of the common duct. In twelve cases in which the duct was reported as patent, surgery demonstrated normal ductus in 10; in one case, the duct was dilated, and in another case, stones were found. In 3 patients where the duct was described as partially obstructed, one was found to be patent, another dilated associated with gallstones, and in the third patient, stones were found in the duct.

The sensitivity for the diagnosis of cholecystitis was 90.9%, and the specificity can't be obtained because the total negative studies are zero.

The sensitivity of HIDA to determine if the common duct is normal was 90.9%, and the specificity was 66.6%.

It is concluded that HIDA constitutes a valuable contribution to the methods employed in the diagnosis of cholecystitis and in corroborating the normality of the common duct.