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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

View larger version (158K): [in a new window]   FIGURE 1. Hepatic bile transit pattern within gallbladder lumen. Outline of fully filled gallbladder is superimposed onto selected earlier frames along with their time of appearance from injection of 99mTc-mebrofenin. Radiolabeled hepatic bile first enters gallbladder at 12 min (upper threshold set for red color) along central long axis of images at 14, 22, 32, 36, and 40 min. Once filled fully with radiolabeled bile, not much change in size of gallbladder is shown in frames 48 through 58 min.

View larger version (24K): [in a new window]   FIGURE 2. Hepatic bile entry pattern into gallbladder. x-Axis shows time in minutes after 99mTc-HIDA injection. y-Axis shows gallbladder area as number of pixels per minute on left and its volume as counts per minute on right. Gallbladder volume curve shows uninterrupted upslope (curve for control not shown to avoid crowding), indicating continuous bile entry during fasting. Transit time (T) is noted (arrow) at intersection of pixel-per-minute line and extrapolation line passing through lowest number of pixels between 50 and 60 min, by which time radiolabeled hepatic bile usually fills gallbladder to its full volume. Note that variation in gallbladder area (due to respiratory movement) beyond 45 min is not accompanied by any reduction in bile volume (counts per minute).

View larger version (19K): [in a new window]   FIGURE 3. Reproducibility of bile transit rate measurement. Transit rate measured independently by 2 observers (Obs 1 and Obs 2) shows good correlation (r = 0.71; P = 0.0004).