Kim E E, Pjura G, Lowry P, Nguyen M, Pollack M
AJR Am J Roentgenol. 1986 Dec;147(6):1177-9. doi: 10.2214/ajr.147.6.1177.
Cholescintigraphy is a sensitive procedure for diagnosing or excluding acute cholecystitis. However, when rapid diagnosis is critical, the requirement for delayed images (4 hr or more after injection) to minimize the false-positive rate diminishes its utility. We prospectively evaluated 40 cholescintigraphic examinations that did not visualize the gallbladder 1 hr after injection of 99mTc diisopropyliminodiacetic acid. These examinations were then augmented by administration of IV morphine, followed by an additional 30 min of imaging. After the morphine, 18 of these examinations demonstrated visualization of the gallbladder; none subsequently required surgical exploration. Of the remaining 22, who demonstrated persistent nonvisualization of the gallbladder post-morphine, 11 were explored surgically and found to be abnormal. The 11 others were treated medically. Low-dose morphine administered when the gallbladder fails to visualize after 1 hr is a useful adjunct to conventional cholescintigraphy because it reduces the time required to obtain a diagnostic result and decreases the number of false-positive results.
肝胆闪烁显像术是诊断或排除急性胆囊炎的一种敏感方法。然而，当快速诊断至关重要时，为将假阳性率降至最低而需要延迟显像（注射后4小时或更长时间）降低了其效用。我们前瞻性地评估了40例在注射99mTc二异丙基亚氨基二乙酸1小时后胆囊未显影的肝胆闪烁显像检查。然后通过静脉注射吗啡并额外进行30分钟的显像来补充这些检查。注射吗啡后，其中18例检查显示胆囊显影；随后均无需手术探查。其余22例在注射吗啡后胆囊仍持续未显影，其中11例接受了手术探查，发现异常。另外11例接受了药物治疗。在胆囊1小时后未显影时给予低剂量吗啡是传统肝胆闪烁显像术的一种有用辅助手段，因为它减少了获得诊断结果所需的时间，并减少了假阳性结果的数量。
