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The Journal of Nuclear Medicine Vol. 28 No. 11 1775-1779
© 1987 by Society of Nuclear Medicine
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Sequential Hepatobiliary Scintigraphy Demonstrating Apparent Transient Biliary Obstruction

Arnold F. Jacobson*, Edward B. Cronin and B. Leonard Holman

Department of Radiology, Brigham and Women's Hospital
Joint Program in Nuclear Medicine, Harvard Medical School, Boston, Massachusetts

Correspondence: For reprints contact: B. Leonard Holman, MD, Dept. of Radiology, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115.

ABSTRACT

A case of acute acalculous cholecystitis in which sequential hepatobiliary scintigraphy demonstrated apparent transient biliary obstruction is presented. An initial technetium-99m diisopropyliminodiacetic acid ([99mTc]DISIDA) study in a patient suspected of acute cholecystitis showed persistent hepatic activity, nonvisualization of the gallbladder, and minimal intestinal activity seen only at 24 hr. Following a second injection of [99mTc]DISIDA administered shortly after the 24-hr image from the first study, the gallbladder and bowel were both visualized within 75 min. At subsequent surgery, acute and chronic cholecystitis were present without evidence of choledocholithiasis or other source of obstruction. Intrahepatic cholestasis following clearance of biliary obstruction may result in late bowel visualization on delayed cholescintigraphic images similar to that seen in partial obstruction. Accurate reflection of the state of hepatobiliary function may require reinjection with [99mTc] DISIDA.

FOOTNOTES

* Present address: VA Medical Center, Seattle, WA.






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Copyright © 1987 by the Society of Nuclear Medicine.