Ziessman Harvey A
Division of Nuclear Medicine, Georgetown University Hospital, Washington, DC, USA.
Semin Nucl Med. 2003 Oct;33(4):279-96. doi: 10.1016/s0001-2998(03)00032-1.
The use of cholescintigraphy to diagnose acute cholecystitis, biliary obstruction, and biliary leakage dates back to the late 1970s. Today, despite the many advances in imaging instrumentation, radiopharmaceuticals, and methodology over these years, cholescintigraphy still plays an important role in confirming or excluding these diagnoses in acutely ill patients. Acute calculous and acalculous cholecystitis, gallbladder perforation, biliary obstruction, and biliary leakage often present as acute abdominal pain, and must be differentiated from other surgical and nonsurgical etiologies with similar symptoms and presentation. Understanding the pathophysiology of acute hepatobiliary diseases is vital for deciding on the most advantageous imaging work-up and for interpretation of the studies. To optimize the value of cholescintigraphy, up-to-date methology, proper use of appropriate pharmacologic interventions, and recognition of characteristic image findings are critical.
使用胆系闪烁显像术诊断急性胆囊炎、胆道梗阻和胆漏可追溯到20世纪70年代末。如今，尽管这些年来成像仪器、放射性药物和方法学有了诸多进展，但胆系闪烁显像术在确诊或排除急性病患者的这些诊断方面仍发挥着重要作用。急性结石性和非结石性胆囊炎、胆囊穿孔、胆道梗阻和胆漏常表现为急性腹痛，必须与具有相似症状和表现的其他外科和非外科病因相鉴别。了解急性肝胆疾病的病理生理学对于决定最有利的影像学检查以及解读检查结果至关重要。为了优化胆系闪烁显像术的价值，最新的方法、合理使用适当的药物干预措施以及识别特征性图像表现至关重要。
