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Submitted: 05 June 2013 Modified: 05 June 2013
HERDIN Record #: PCHRD13060509570789

Cholescintigraphy in the evaluation of cholecystitis.

Cynthia U. Liao,
Giselle Villanueva

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The aim of this study is to re-assess the value of cholescintigraphy in terms of its sensitivity, specificity, and positive and negative predictive values in diagnosing acute and chronic cholecystitis. Out of 96 cho/escintigrams of symptomatic patients suspected for acute cholecystitis performed at St. Luke's Medical Center from 2000 to 2012, only 25 patients who eventually underwent cholecystectomy were included in the data analysis. The histopathologic diagnosis was taken as the gold standard. Nineteen scans were read as positive for cystic duct obstruction indicative of acute cholecystitis. Of these, only 10 were congruent with histopathology. The remainder had pathologic chronic cholecystitis. The sensitivity of cho/escintigraphy for diagnosing acute cholecystitis was 91 %, the specificity was 36%, and the positive and negative predictive values were 53% and 83%, respectively. Six scintigrams with delayed gallbladder visualization were read as chronic cholecystitis. Histopathologic results of these showed 5 with chronic cholecystitis and 1 with evidence of acute cholecystitis. For diagnosing chronic cholecystitis, cho/escintigraphy has a sensitivity of 36%, specificity of 91 %, positive predictive value of 83% and negative predictive value of 53%. In conclusion, nonvisualization of the gallbladder on cholescintigraphy is not a sine qua non for acute cholecystitis. Although the test has high sensitivity for diagnosing acute cholecystitis, high false positivity was obtained due to chronic cholecystitis. Moreover, cholescintigraphy has limited value in diagnosing the chronic form of the disease as demonstrated by its low sensitivity.

Publication Type
Journal
Publication Sub Type
Clinical trials/Clinical investigations (RCT's)
Title
The Philippine Journal of Nuclear Medicine
Frequency
Semi-Annual
Publication Date
January-June 2013
Volume
8
Issue
1
Page(s)
8-11
LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Box No. 21 Fulltext Print Format (Request Document)