Evaluation of hepatobiliary imaging using Tc-99m-DISIDA in hepatobiliary disease

ABSTRACT

Hepatobiliary scintigraphy using Tc-labelled radiopharmaceuticals is employed primarily for the diagnosis ofacute cholecystitis and for demonstration of biliary tract patency. We conducted a retrospective study of 55patients with hepatobiliary disease from Jun. '84 to Sep. '84 at Taegu Catholic Hospital and tried to determinethe etiology and fine the possible differential points by analyzing the scintigraphic findings. The followingresults were obtained 1. Tree-like photon defect on hepatic parenchyme was suggested characteristic of completeobstructive biliary diseases, but could be seen in either benign or malignant etiology. 2. The grade of hepatocyteclearance was not useful in detemining whether the cause of obstructive biliary disease was benign or malignant inthis study. 3. Hepatocyte clearance was more severely impaired in hepatocellular disease than in obstructivebiliary disease. 4. The photon defect in porta hapatis with complete biliary obstruction was suggestedcharacteristic of common bile duct cancer. 5. The meniscus appearance at obstructed site of common bile duct waspathognomonic sign of choledocholithiasis. 6. When the gallbladder was not visualized, the differential diagnosisbetween acute and chronic cholecystitis was possible without delayed image by observing the transist time tobowel. The delayed transit to bowel was a favorable of chronci cholecystitis rather than of acute cholecystitis.7. Acute pancreatitis could be easily differentiated from partial biliary obstruction by clinical and laboratoryexamination, but the finding of abrupt narrowing of pancreatic common bile duct with sligt proximal dilatation oncholescintigraphy was also a key point in acute pancreatitis. 8. The segmental dilatation of intrahepatic duct wasthought meaningful sign of clonorchiasis.