Krishnamurthy Gerbail T, Krishnamurthy Shakuntala
Department of Nuclear Medicine, Tuality Community Hospital, Hillsboro, Oregon 97123, USA.
Nucl Med Commun. 2010 May;31(5):346-54. doi: 10.1097/MNM.0b013e32832fa2c0.
To explore the extension of cholecystokinin-cholescintigraphy in the evaluation of abdominal pain.
A total of 1554 patients with abdominal pain underwent Tc-mebrofinin cholescintigraphy. Gallbladder ejection fraction was obtained with cholecystokinin (sincalide) and abdominal pain was graded.
Fourteen different types of hepatobiliary and gastrointestinal motility disorders were identified. Biliary dyskinesia was found in 453 patients, septate gallbladder in 33, and duodeno-gastric bile reflux in 46 patients. Sincalide-induced intestinal hyperperistalsis alone was found in 65 and in combination with other diseases in 64 patients. Abdominal pain was mild to moderate in intensity, and occurred in 50-60% of patients with abnormal gallbladder function. Severe abdominal pain was usually associated with intestinal hyperperistalsis.
Tc-mebrofinin cholescintigraphy enables the identification of motility disorders of the gastrointestinal and hepatobiliary tract, and post-sincalide abdominal pain in most cases can be assigned to functional abnormality of the gallbladder or/and intestine.
探讨胆囊收缩素-胆管闪烁显像在腹痛评估中的应用拓展。
共1554例腹痛患者接受了锝-美布芬宁胆管闪烁显像。通过胆囊收缩素(辛卡利特)测定胆囊排空分数,并对腹痛进行分级。
识别出14种不同类型的肝胆和胃肠动力障碍。453例患者存在胆囊运动功能障碍,33例有分隔胆囊,46例有十二指肠-胃胆汁反流。单独出现辛卡利特诱导的肠道蠕动亢进的患者有65例,与其他疾病合并出现的有64例。腹痛程度为轻至中度,在胆囊功能异常的患者中发生率为50% - 60%。严重腹痛通常与肠道蠕动亢进有关。
锝-美布芬宁胆管闪烁显像能够识别胃肠道和肝胆道的动力障碍,在大多数情况下,注射辛卡利特后的腹痛可归因于胆囊或/和肠道的功能异常。