Fink-Bennett D, DeRidder P, Kolozsi W, Gordon R, Rapp J
J Nucl Med. 1985 Oct;26(10):1123-8.
Fourteen patients with a cystic duct syndrome (CDS) underwent cholecystokinin (CCK) cholescintigraphy. All patients presented with persistent postprandial right upper quadrant pain and biliary colic. None of the patients had an abnormal oral cholecystography, gallbladder (GB) ultrasound exam or upper GI series. Each patient (NPO after 12 a.m.) received 5 mCi of technetium-99m disofenin. When the GB maximally filled, 0.02 microgram/kg CCK was administered (3 min) intravenously. Background corrected gallbladder ejection fractions (GBEFs) were determined every 5 min X 4 by rationing the pre-CCK GB counts minus post-CCK GB counts to pre-CCK GB counts. GBEFs were: 12% (3 patients), 17% (2), 0%, 1.3%, 3%, 4%, 6%, 11%, 14%, 18.5%, and 22% (1 each). All patients underwent a surgical exploration and all had macro- or microscopically abnormal cystic ducts (five fibrotic, seven elongated and narrow, two kinked) with (12 patients) or without (2 patients) concomitant chronic cholecystitis. No patient with a partially occluded cystic duct with or without concomitant chronic cholecystitis had an ejection fraction that exceeded 22%. In an appropriate clinical setting, a low EF response to CCK should alert the physician to the presence of either chronic acalculous cholecystitis, CDS, or the combination of both.
14例胆囊管综合征（CDS）患者接受了胆囊收缩素（CCK）胆囊闪烁扫描检查。所有患者均表现为餐后持续性右上腹疼痛和胆绞痛。所有患者口服胆囊造影、胆囊（GB）超声检查或上消化道造影均无异常。每位患者（上午12点后禁食）接受5毫居里的锝-99m二乙三胺五醋酸。当胆囊充盈最大时，静脉注射0.02微克/千克CCK（持续3分钟）。通过将注射CCK前胆囊计数减去注射CCK后胆囊计数与注射CCK前胆囊计数的比值，每5分钟测定一次背景校正后的胆囊排空分数（GBEFs），共测定4次。GBEFs分别为：12%（3例患者）、17%（2例）、0%、1.3%、3%、4%、6%、11%、14%、18.5%和22%（各1例）。所有患者均接受了手术探查，所有患者的胆囊管均有宏观或微观异常（5例纤维化、7例细长狭窄、2例扭曲），伴有（12例患者）或不伴有（2例患者）慢性胆囊炎。没有一例胆囊管部分阻塞伴或不伴慢性胆囊炎的患者其排空分数超过22%。在适当的临床情况下，对CCK的低EF反应应提醒医生注意慢性非结石性胆囊炎、CDS或两者并存的情况。
