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Reflux Sign in Cholescintigraphy After Administration of a Gallbladder Contracting Agent

Department of Radiology, Matsunami General Hospital, Gifu and Department of Radiology, Ehime University School of Medicine, Ehime, Japan

Correspondence: For reprints contact: Hisao Itoh, MD, Dept. of Radiology, Matsunami General Hospital, 185-1 Dendai, Kasamatsu-cho, Hashima-gun, Gifu 501-06, Japan.

ABSTRACT

This study reviewed 12 patients with the reflux sign in cholescintigraphy to assess its diagnostic usefulness in evaluating biliary passage. The reflux sign was determined by appearance or increase of the radioactivity in peripheral intrahepatic bile ducts after intramuscular injection of 10 µg of ceruletide diethylamine (caerulein). Of the 12 patients, there were common bile duct (CBD) stone in four, chronic pancreatitis in two, biliary dyskinesia in two, papillary adenoma of the CBD, dilated CBD, papillitis, and juxtapapillary duodenal diverticulum in one each. Cholangiographically, dilated caliber of the CBD more than or equal to 12 mm was found in five and equivocal caliber of 8 to 11 mm was in the remaining seven. Apparent stenosis of the CBD was found in four with dilated CBD. There were two patients who had CBD stone with equivocal caliber of the CBD. The reflux sign seems to be a sensitive finding indicating the presence of biliary dysfunction, and would be helpful for the detection of incomplete obstruction of the CBD or CBD stone, especially in a patient with equivocal caliber of the CBD.