Itoh H, Murase K, Hamamoto K
Department of Radiology, Matsunami General Hospital, Gifu, Japan.
J Nucl Med. 1989 Jul;30(7):1192-7.
This study reviewed 12 patients with the reflux sign in cholescintigraphy to assess its diagnostic usefulness in evaluating biliary passage. The reflux sign was determined by appearance or increase of the radioactivity in peripheral intrahepatic bile ducts after intramuscular injection of 10 micrograms of ceruletide diethylamine (caerulein). Of the 12 patients, there were common bile duct (CBD) stone in four, chronic pancreatitis in two, biliary dyskinesia in two, papillary adenoma of the CBD, dilated CBD, papillitis, and juxtapapillary duodenal diverticulum in one each. Cholangiographically, dilated caliber of the CBD more than or equal to 12 mm was found in five and equivocal caliber of 8 to 11 mm was in the remaining seven. Apparent stenosis of the CBD was found in four with dilated CBD. There were two patients who had CBD stone with equivocal caliber of the CBD. The reflux sign seems to be a sensitive finding indicating the presence of biliary dysfunction, and would be helpful for the detection of incomplete obstruction of the CBD or CBD stone, especially in a patient with equivocal caliber of the CBD.
本研究回顾了12例在胆管闪烁造影中有反流征象的患者，以评估其在评估胆道方面的诊断价值。反流征象通过肌肉注射10微克二乙胺促胰液素（雨蛙肽）后肝内周边胆管放射性的出现或增加来确定。12例患者中，4例有胆总管结石，2例有慢性胰腺炎，2例有胆道运动障碍，1例有胆总管乳头状腺瘤、胆总管扩张、乳头炎和十二指肠乳头旁憩室。胆管造影显示，5例胆总管口径扩张大于或等于12毫米，其余7例口径为8至11毫米，不明确。4例胆总管扩张患者发现胆总管明显狭窄。有2例患者有胆总管结石但胆总管口径不明确。反流征象似乎是提示胆道功能障碍存在的一个敏感发现，有助于检测胆总管不完全梗阻或胆总管结石，特别是在胆总管口径不明确的患者中。
