Watson A, Kalff V
Alfred Hospital, Melbourne, Australia.
Curr Opin Radiol. 1991 Dec;3(6):851-8.
Recent publications continue to refine the technique and interpretation of hepatobiliary scanning. Studies related to the evaluation of suspected acute cholecystitis have shown that morphine-augmented hepatobiliary imaging may not overcome the problem of false-positive study results in severely ill patients and the criterion for a normal study should be gallbladder visualization within 30 rather than 60 minutes. In patients with suspected acute cholecystitis, nonvisualized extrahepatic activity despite good hepatic uptake is highly predictive of acute cholecystitis, usually with biliary obstruction. The limitations of cholecystokinin-hepatobiliary imaging studies in patients with abdominal pain syndromes were defined and its use in evaluating common bile duct dynamics, and duodenogastric reflux was explored. Unusual findings and less-common uses of hepatobiliary scanning were reported, including assessment of conjoined twins, liver transplantation, primary biliary cirrhosis, gallbladder perforation, and persistent splenic visualization.
近期发表的文献不断完善肝胆扫描技术及解读。与疑似急性胆囊炎评估相关的研究表明，吗啡增强的肝胆成像可能无法解决重症患者假阳性研究结果的问题，正常研究的标准应为30分钟而非60分钟内胆囊显影。在疑似急性胆囊炎患者中，尽管肝脏摄取良好但肝外无显影高度提示急性胆囊炎，通常伴有胆道梗阻。明确了腹痛综合征患者中胆囊收缩素 - 肝胆成像研究的局限性，并探讨了其在评估胆总管动力学及十二指肠胃反流方面的应用。报告了肝胆扫描的异常发现及较少见的用途，包括联体双胎评估、肝移植、原发性胆汁性肝硬化、胆囊穿孔及脾脏持续显影。
