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Differential Gallbladder Contractility in Fundal Adenomyomatosis: Demonstration by Cholecystokinin Cholescintigraphy

Departments of Diagnostic Radiology, Pathology, and Surgery, Morristown Memorial Hospital in Morristown, New Jersey

Correspondence: For reprints contact: Lawrence C. Swayne, MD, Diagnostic Radiology, Morristown Memorial Hospital, Morristown, NJ 07960.

ABSTRACT

The Cholecystokinin cholescintigraphic findings of fundal adenomyomatosis in a 29-yr-old male with severe post-prandial pain are presented. Planar Cholescintigraphy demonstrated a trilobed gallbladder contour. Following the administration of 0.02 µg/kg of Cholecystokinin at maximal gallbladder filling, fundal dyskinesia was observed. Regional gallbladder ejection fractions were: whole gallbladder, 43%; proximal two-thirds of the gallbladder, 70%; and gallbladder fundus, 32%. First harmonic Fourier phase and amplitude images demonstrated: (a) decreased fundal amplitude values, and (b) a phase shift of the pixels in the gallbladder fundus.