Iqbal Mohammed, Aggarwal Sandeep, Kumar Rakesh, Garg Pramod Kumar, Bandhu Suman, Kumar Arvind, Parshad Rajinder, Guleria Sandeep
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
Nucl Med Commun. 2004 Mar;25(3):285-9. doi: 10.1097/00006231-200403000-00012.
A dilated common bile duct and/or elevated serum alkaline phosphatase, raises a suspicion of bile duct stone(s) in patients with gallstones. Cholangiography, either endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP), is the best method for diagnosing bile duct stones. ERCP has the disadvantage of being invasive, and there is a risk of complications; while MRCP is costly and is not widely available.
The objective of the present study was to evaluate the role of hepatobiliary nuclear scanning in diagnosing bile duct stones.
Twenty-five patients with suspected common bile duct (CBD) stones underwent hepatobiliary scintigraphy. The results of scintigraphy were compared with cholangiograms obtained by ERCP in 11 patients and MRCP in 14 patients, considering MRCP/ERCP as the 'gold standard'.
Scintigraphy showed features suggestive of CBD stones in 11 of the 25 patients. The results of ERCP/MRCP confirmed that eight of them had stones. Scintigraphy showed no features of CBD stones in the remaining 14 patients. ERCP/MRCP showed CBD stones in two of these 14 patients. Thus, scintigraphy had a sensitivity of 80% and a specificity of 80%.
We conclude that scintigraphy has good sensitivity and specificity in predicting CBD stones in patients with gallstone disease and a dilated CBD.
在胆结石患者中，胆总管扩张和/或血清碱性磷酸酶升高提示可能存在胆管结石。胆管造影，即内镜逆行胰胆管造影（ERCP）或磁共振胰胆管造影（MRCP），是诊断胆管结石的最佳方法。ERCP具有侵入性的缺点，且存在并发症风险；而MRCP成本高昂且尚未广泛应用。
本研究的目的是评估肝胆核素扫描在诊断胆管结石中的作用。
25例疑似胆总管（CBD）结石的患者接受了肝胆闪烁扫描。将闪烁扫描结果与11例患者的ERCP胆管造影结果以及14例患者的MRCP胆管造影结果进行比较，将MRCP/ERCP视为“金标准”。
闪烁扫描显示25例患者中有11例具有提示CBD结石的特征。ERCP/MRCP结果证实其中8例有结石。其余14例患者的闪烁扫描未显示CBD结石特征。ERCP/MRCP显示这14例患者中有2例有CBD结石。因此，闪烁扫描的敏感性为80%，特异性为80%。
我们得出结论，闪烁扫描在预测胆结石病且CBD扩张患者的CBD结石方面具有良好的敏感性和特异性。
