Semaan Hassan, Elsamaloty Haitham, Bazerbashi Mohamad, Obri Joud, Elsamaloty Mazzin, Arroyo Alberto J, Obri Tawfik
Department of Radiology, University of Toledo Medical Center, Toledo, OH, USA.
Department of Radiology, Nuclear Medicine, St. Vincent Mercy Medical Center, Toledo, OH, USA.
BJR Open. 2020 Dec 21;2(1):20200008. doi: 10.1259/bjro.20200008. eCollection 2020.
Tc99m methoxy isobutyl isonitrile (MIBI) has been used for myocardial perfusion imaging (MPI) for the detection of ischemia. This study aimed to investigate the feasibility of effectively evaluating cystic duct patency, during routine visual analysis of the raw MPI and/or with the three-dimensional reconstructed data.
A retrospective investigation of 91 patients undergoing cardiac MIBI scan for acute chest pain and hepatobiliary scintigraphy (HBS) was performed, within no more than 3 months for suspected gallbladder obstructive disease. Gallbladder visualization during either the stress or rest portion of the MIBI was indicative of cystic duct patency. These results were compared to those by the HBS studies.
Ten patients had the MIBI and HBS 4 days apart, both analyses concurred 100% with the diagnosis of cystic duct patency. 16 patients had both examinations between 4 days and 3 weeks and had an agreement of 87.5% with cystic duct patency. 65 patients had both tests 3 weeks to 3 months apart and had an agreement of 84.6% with cystic duct patency.
The initial results of this study indicate that MPI with Tc99m MIBI is useful in detecting a patent cystic duct, above all in the setting of acute gallbladder pathology.
In this article, we introduce a novel method to diagnose cystic duct patency in the acute setting thus effectively ruling out acute cholecystitis, during MPI. Our method can potentially improve patient outcomes by reducing the volume of imaging needed to exclude a diagnosis of acute gallbladder pathology. This in turn, keeps in line with decreasing the cost for the patient, leading to a more sound value-based care.
锝99m甲氧基异丁基异腈（MIBI）已用于心肌灌注显像（MPI）以检测心肌缺血。本研究旨在探讨在对原始MPI进行常规视觉分析和/或使用三维重建数据时有效评估胆囊管通畅性的可行性。
对91例因急性胸痛接受心脏MIBI扫描及肝胆闪烁显像（HBS）的患者进行回顾性研究，这些患者因疑似胆囊梗阻性疾病在不超过3个月的时间内接受检查。MIBI负荷或静息期胆囊显影提示胆囊管通畅。将这些结果与HBS研究结果进行比较。
10例患者MIBI和HBS检查间隔4天，两种分析对胆囊管通畅性诊断的一致性为100%。16例患者两次检查间隔4天至3周，对胆囊管通畅性的一致性为87.5%。65例患者两次检查间隔3周至3个月，对胆囊管通畅性的一致性为84.6%。
本研究的初步结果表明，锝99m MIBI心肌灌注显像在检测胆囊管通畅方面是有用的，尤其是在急性胆囊病变的情况下。
在本文中，我们介绍了一种在急性情况下诊断胆囊管通畅性的新方法，从而在心肌灌注显像期间有效排除急性胆囊炎。我们的方法有可能通过减少排除急性胆囊病变诊断所需的成像量来改善患者预后。这反过来又符合降低患者费用的要求，从而实现更合理的基于价值的医疗。
