Radiology, Vol 151, 197-201, Copyright © 1984 by Radiological Society of North America
Sclerosing cholangitis: cholescintigraphy with Tc-99m-labeled DISIDA
AE Ament, RJ Bick, FD Miraldi, JR Haaga and SD Wiedenmann
Four patients with primary sclerosing cholangitis (PSC) were examined with
the hepatobiliary agent Tc-99m-labeled DISIDA (diisopropylphenylcarbamoyl
iminodiacetic acid), and the results correlated with those of invasive
cholangiography. Three of the four patients exhibited a typical pattern of
multiple, persistent focal "hot spots" in the duct system, representing
stasis within the segmental ductal dilatations (beading), also seen on
cholangiography. Cholescintigraphy is superior to cholangiography in cases
of suspected PSC where there is nonfilling of biliary radicals due to
high-grade stenosis. The finding of delayed hepatic parenchymal clearance
can allow estimation of the degree of obstruction of the various branches
of the major bile ducts. Cholescintigraphy offers a noninvasive method of
investigating patients with suspected sclerosing cholangitis, leading to
earlier diagnosis. Confirmation with invasive cholangiographic procedures
is recommended.
