HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Krishnamurthy, G. T. Articles by Krishnamurthy, S. Search for Related Content PubMed PubMed Citation Articles by Krishnamurthy, G. T. Articles by Krishnamurthy, S.

Hepatic Bile Entry Into and Transit Pattern Within the Gallbladder Lumen: A New Quantitative Cholescintigraphic Technique for Measurement of Its Concentration Function

Nuclear Medicine Department, Tuality Community Hospital, Tuality Healthcare, Hillsboro, Oregon

The aim of the project was to study hepatic bile entry into and the transit pattern within the gallbladder lumen during fasting and to introduce a new quantitative scintigraphic test for measurement of its concentration function. Methods: Each of 10 control subjects and 10 chronic acalculous cholecystitis (CAC) patients received 111–185 MBq ^99mTc-mebrofenin as a hepatic bile marker. Gamma-camera image data were collected in the anterior view on a 128 x 128 x 16 computer matrix at 1 frame per minute for 60 min for the hepatic phase and 30 min for the gallbladder phase. The radiolabeled hepatic bile area within the gallbladder lumen was traced, and the net transit area and transit time were noted. The hepatic bile transit rate was calculated (as mm²/min) and normalized to 1,000 mm² of the anterior gallbladder area. The cholecystokinin-8–induced ejection fraction was calculated nongeometrically using counts. Results: Hepatic bile entered the gallbladder continuously during fasting with a mean ± SD of 71% ± 20% in control subjects and 59% ± 27% in CAC patients, which were not significantly different (P > 0.05). The maximum frontal gallbladder area was 1,699 mm² in control subjects and 1,610 mm² in CAC patients (P > 0.05). Radiolabeled hepatic bile entered the gallbladder first along its central long axis in both groups, at a mean of 15 min and 16 min, respectively, and traveled toward the periphery in a lamellar fashion at a normalized mean rate of 38 mm²/min and 40 mm²/min in control subjects and CAC patients, respectively. The mean ejection fraction of 17% in CAC patients was significantly lower than the mean value of 56% in control patients (P < 0.00001). Conclusion: Hepatic bile enters the gallbladder continuously during fasting. In patients with CAC, the gallbladder maintains the normal concentration function but the contraction and emptying are reduced significantly. This new cholescintigraphic technique enables measurement of both functions sequentially with a single dose of ^99mTc-mebrofenin.

Key Words: hepatic bile flow • gallbladder concentration • gallbladder contraction • cholescintigraphy • cholecystitis

This article has been cited by other articles:

				G. T. Krishnamurthy, S. Krishnamurthy, and P. H. Brown Constancy and Variability of Gallbladder Ejection Fraction: Impact on Diagnosis and Therapy J. Nucl. Med., November 1, 2004; 45(11): 1872 - 1877. [Abstract] [Full Text] [PDF]