RT Journal Article
SR Electronic
T1 Chronic acalculous cholecystitis in children with biliary symptoms: Usefulness of hepatobiliary cholescintigraphy
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 365
OP 365
VO 55
IS supplement 1
A1 Kwatra, Neha
A1 Grant, Frederick
A1 Falone, Anthony
A1 Treves, S. Ted
YR 2014
UL http://jnm.snmjournals.org/content/55/supplement_1/365.abstract
AB 365 Objectives Acalculous cholecystitis increasingly is recognized as a cause of recurring biliary symptoms in adolescent females, but its diagnosis remains challenging. The aim of this study was to evaluate the utility of hepatobiliary cholescintigraphy in children with suspected acalculous cholecystitis. Methods We reviewed medical records of patients (age 9-20 years) who underwent cholescintigraphy from February 2009 to January 2011. Patients with gallstones and those with a clinical follow-up of ≤1year were excluded. Studies in which gallbladder stimulation was not performed were also excluded. Gallbladder ejection fraction of ≤ 35% after a 30-minute infusion of cholecystokinin-8 (CCK, 0.02µg/kg) or a 30 ml fatty meal (Lipomul) was considered abnormal. Diagnosis of chronic acalculous cholecystitis was based on pathology following cholecystectomy. Patients with negative gallbladder pathology, complete resolution of symptoms on follow-up, or alternative diagnoses for persistent symptoms were considered not to have acalculous cholecystitis. Results Fifty-five of the 110 patients who underwent cholescintigraphy formed the study group. Mean patient age was 14.8 years. There was female preponderance (87%). Median symptom duration was 7 months (interquartile range, 1-19 months). The most common symptom was abdominal pain (96%). Median duration of clinical follow-up was 2.9 years (interquartile range, 1.8-3.7 years). Forty-one patients had at least one study with CCK (48 scans) and 17 patients with Lipomul (20 scans). Cholescintigraphy was 82% sensitive and 85% specific in diagnosing acalculous cholecystitis, with a negative predictive value of 94%. Conclusions Hepatobiliary cholescintigraphy is useful for excluding acalculous cholecystitis as a cause of chronic or recurrent abdominal pain in adolescent females.