Jazrawi R P, Pazzi P, Petroni M L, Prandini N, Paul C, Adam J A, Gullini S, Northfield T C
Department of Medicine, St. George's Hospital Medical School, London, England.
Gastroenterology. 1995 Aug;109(2):582-91. doi: 10.1016/0016-5085(95)90348-8.
BACKGROUND & AIMS: Impaired gallbladder emptying is implicated in gallstone disease. Ultrasonography and scintigraphy have shown conflicting results because the former is influenced by postprandial refilling, whereas the latter is not influenced by refilling. The aim of this study was to measure postprandial refilling and turnover of bile by combining the two techniques.
Simultaneous scintigraphy and ultrasonography were used in 14 patients with gallstones and 11 healthy controls. Measurements were performed while the patients were fasting and at 10-minute intervals after a standard meal for 90 minutes, and the measurements were used to calculate postprandial refilling, turnover of bile (in milliliters), and turnover index.
Ultrasonography and scintigraphy provided different gallbladder emptying patterns. Compared with controls, patients with gallstones had impaired emptying by both scintigraphy (P < 0.0001) and ultrasonography (P < 0.01). Postprandial refilling and turnover were both reduced between 60 and 90 minutes (P < 0.05), and the turnover index was markedly reduced (1.8 vs. 3.5; P < 0.001).
Simultaneous scintigraphy and ultrasonography provide a new model of gallbladder motor function showing that refilling begins immediately postprandially. In healthy controls, the gallbladder postprandially handles up to six times its basal volume within a period of 90 minutes, but this turnover of bile is markedly reduced in cholelithiasis causing a reduced washout effect of the gallbladder contents, including cholesterol crystals.
胆囊排空功能受损与胆结石疾病有关。超声检查和闪烁扫描显示出相互矛盾的结果，因为前者受餐后再充盈的影响，而后者不受再充盈的影响。本研究的目的是通过结合这两种技术来测量餐后胆汁的再充盈和周转率。
对14例胆结石患者和11名健康对照者同时进行闪烁扫描和超声检查。在患者禁食时以及标准餐后每隔10分钟进行测量，持续90分钟，并利用这些测量结果计算餐后再充盈、胆汁周转率（以毫升为单位）和周转率指数。
超声检查和闪烁扫描呈现出不同的胆囊排空模式。与对照组相比，胆结石患者通过闪烁扫描（P < 0.0001）和超声检查（P < 0.01）均显示排空功能受损。餐后60至90分钟期间，再充盈和周转率均降低（P < 0.05），且周转率指数显著降低（1.8对3.5；P < 0.001）。
同时进行闪烁扫描和超声检查提供了一种新的胆囊运动功能模型，表明餐后立即开始再充盈。在健康对照者中，胆囊在90分钟内餐后可处理多达其基础容积六倍的胆汁，但在胆石症中这种胆汁周转率显著降低，导致胆囊内容物（包括胆固醇晶体）的冲刷作用减弱。
