Radiology, Vol 180, 43-45, Copyright © 1991 by Radiological Society of North America
Optimal technique for detection of gallstones at injection cholecystography: in vitro analysis
B Kammer, S Saini, JA Brink, WT Knoefel, JT Ferrucci, JF Simeone and PR Mueller
Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston 02114.
Injection cholecystography is often employed during invasive gallbladder
procedures to determine the number of gallstones that are present. The
authors undertook this study to define the optimal radiographic technique
for performance of injection cholecystography. Condoms filled with 100 mL
of contrast medium at four different iodine concentrations (30%, 15%, 7.5%,
and 3.8% [wt/vol]) and containing up to five 4-mm-thick gallstones or a
single 10-mm-thick gallstone were radiographed in a 20-cm-deep water bath
by using four kilovolt peak settings (70, 80, 90, and 100 kVp). Images were
read by three radiologists who were blinded to the radiographic technique.
significantly (P less than .05) improved Decreasing iodine concentration
significantly (P less than .05) improved detection of 4- mm-thick
gallstones at a constant kilovolt peak setting. However, increasing the
kilovolt peak setting while using the same concentration of contrast medium
had no statistically significant influence on gallstone detectability,
although radiologists did indicate a preference for the high-kilovolt peak
technique. Results of the authors' experiments showed that for detection of
small gallstones at injection cholecystography, use of a low-concentration
contrast medium and a high kilovolt peak setting is the recommended
radiographic technique.
