Cholescintigrphy 의 적응증 및 그 의의 = Indication and Significance of CholescintigrphyCholescintigrphy 의 적응증 및 그 의의

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Recently, when the hepatobiliary disease was suspected, the ultrasonography was performed usually for screening test in most hospital. Since the introduction of technetium -99m- labeled cholescintigraphic agent in the mid-1970s, there has been extensive investigation of their diagnostic value and significance as screening test of biliary tract disorders. The diagnostic value of cholescintigraphy was accepted in diagnosis of acute cholecystitis, but the other diagnostic value of cholescintigraphy is remained controversy in diagnosis of other hepatobiliary diseases. Therefore, we conducted a retrospective study of 152 patients that had been performed cholescintigraphy at Wonkwang University from 1984. The result of cholescintigraphic findings were classified into 7 criterias as follow, without information of patients history, physical findings and laboratory data, criteria 1; normal cholescintigraphy (all visualization within 1 hour) criteria 2; acute cholecystitis (non-visualization of gall-bladder within 2 hours, prompt hepatic uptake, good CBD and bowel excretion), criteria 3; chronic cholecystitis (prompt hepatic uptake, good bowel and CBD excretion, delayed visualization of gall-bladder within 2 hours), criteria 4; complete CBD obstruction (non-visualization except liver), criteria 5; partial CBD obstruction (delayed biliary tree excretion), criteria 6; poor hepatic uptake, criteria 7; functional CBD obstruction (gall bladder, CBD visualization within 1 hour but no bowel activity). We classified the patient into 7 criterias of cholescintigraphic findings and compared the cholescintigraphic findings to the confirmed diagnosis. The results are as fotlows; 1) The cholescintigraphy was valuable study to rule out the acute cholecystitis in the patient who was suspected as other disease. 2) When the acute cholecystitis was suspected primarily, cholescintigraphy was valuable method, but on comparing the diagnostic value of ultrasonography, there was no significant difference. 3) The 5 cases among the 10 cases that were classified as chronic cholscystitis(criteria 3) were false positve. The cholescintigraphy was not valuabe method for diagnosis of chronic cholecystitis. 4) When the findings of cholescintigraphy showed partial or complete biliary obsruction, 16 cases of 17 cases were true positve. Therefore, these cholescitigraphic findings seemed to be valuable in diagnosis of biliary obsruction, but the 16 cases among the total 35 cases of bilary obstruction in all criterias were detected in cholescintigraphy. So, the sensitivity of this study was 45.7%.