Fink-Bennett D, Balon H, Robbins T, Tsai D
Department of Nuclear Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073.
J Nucl Med. 1991 Jun;32(6):1231-3.
Cholescintigrams were performed in 158 patients suspected of having acute cholecystitis after administration of 185 Mbq (5 mCi) of 99mTc-mebrofenin or disofenin. Morphine sulfate, 0.04 mg/kg was given intravenously if there was nonvisualization of the gallbladder at 40-60 min provided that radiotracer was seen within the small bowel. Acute cholecystitis was deemed present if there was nonvisualization of the gallbladder 30 min post-morphine administration; no cystic duct obstruction was present if the gallbladder was demonstrated pre- or post-morphine administration. A final diagnosis was estimated in 51 postoperative patients histologically, the remainder having their final diagnosis gleaned from their medical records. The sensitivity, specificity, positive and negative predictive value of morphine-augmented cholescintigraphy in detecting acute cholecystitis was 94.6, 99.1, 97.2, and 98.3%, respectively. These findings indicate that morphine-augmented cholescintigraphy detects acute cholecystitis with as high a degree of accuracy as conventional hepatobiliary scintigraphy, yet requires only 1.5 hr to establish the diagnosis.
对158例疑似急性胆囊炎的患者，在静脉注射185兆贝可（5毫居里）的99m锝-甲溴菲宁或二巯基丁二酸后进行了胆囊闪烁扫描。如果在40 - 60分钟时胆囊未显影且示踪剂在小肠内可见，则静脉注射0.04毫克/千克硫酸吗啡。如果在注射吗啡后30分钟胆囊仍未显影，则判定为急性胆囊炎；如果在注射吗啡前后胆囊均显影，则不存在胆囊管梗阻。对51例术后患者进行了组织学最终诊断，其余患者的最终诊断则从其病历中获取。吗啡增强胆囊闪烁扫描检测急性胆囊炎的敏感性、特异性、阳性预测值和阴性预测值分别为94.6%、99.1%、97.2%和98.3%。这些结果表明，吗啡增强胆囊闪烁扫描检测急性胆囊炎的准确性与传统肝胆闪烁扫描相当，但仅需1.5小时即可确诊。
