Radiology, Vol 156, 797-800, Copyright © 1985 by Radiological Society of North America
Pericholecystic hepatic activity in cholescintigraphy
R Smith, JM Rosen, LN Gallo and PO Alderson
Gallbladder nonvisualization in cholescintigraphy has been shown to be a
reliable finding in acute cholecystitis. In some cholescintigrams, we have
observed faintly increased pericholecystic hepatic activity in conjunction
with gallbladder nonvisualization. To determine the frequency and
significance of the pericholecystic hepatic activity finding, we evaluated
334 consecutive adult patients who had cholescintigrams with technetium-99m
diisopropylphenylcarboamoyl iminodiacetic acid. Pericholecystic hepatic
activity was seen in 21% of the abnormal scans demonstrating gallbladder
nonvisualization but in none of the other scans. Thirteen of these patients
underwent surgery; 11 (85%) were found to have acute cholecystitis, and two
(15%) had chronic cholecystitis. Four patients (31%) had acute gangrenous
cholecystitis, and five (39%) had cholecystitis complicated by gallbladder
perforation. The pericholecystic hepatic activity sign is not specific for
gangrenous cholecystitis or gallbladder perforation but does reliably
indicate inflammatory gallbladder disease and is associated with a
relatively high incidence of cholecystitis complicated by perforation.
