Quantitative cholescintigraphy: assessment of gallbladder filling and emptying and duodenogastric reflux.
Quantitative cholescintigraphy: assessment of gallbladder filling and emptying and duodenogastric reflux.
复制标题
定量胆道闪烁显像：评估胆囊充盈和排空以及十二指肠胃反流。
DOI：
10.1016/0016-5085(80)90448-5
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发表时间：
1980
期刊：
影响因子：
29.4
通讯作者：
H. Duggan
中科院分区：
文献类型：
--
作者：
Eldon A. Shaffer;P. McOrmond;H. Duggan
为了准确定量与胆囊充盈和排空相关的动态事件，我们开发了一种胆道核素显像技术，通过连接到计算机进行数据处理的伽马相机在外部测量胆汁中排泄的放射性核素99mTC-HIDA。测量肝脏、胆管、胆囊、小肠和胃的活动随时间的变化。前60min用于检测胆囊壁充盈活动。然后以0.020 U/kg/m in的速度注入缩胆囊素30min，同时监测放射性核素进入小肠和/或胃的排空情况。胃区由99mTc-硫磺胶体吞咽确定。在计算机的帮助下，我们能够测量胆囊充盈率、肝脏活动进入胆囊区而不是十二指肠的比例、胆囊排空率以及任何胃反流。在12名禁食的健康受试者中，四分之三的肝脏活动进入了胆囊区。延迟5分钟后，胆囊开始排空，12分钟内排出一半内容物，但30分钟后仍有25%残留。6例胆石症患者的胆囊排空明显较慢，尽管充盈正常。1例胆结石患者在鹅去氧胆酸治疗4个月后进行了重复研究：胆囊充盈，尤其是排空恶化。胃反流仅发生在2例胃肠吻合术患者，他们将2%的胆囊内容物回流到残胃中。定量胆道核素扫描为确定胆汁功能和记录胆汁反流提供了一种新的客观手段。
To accurately quantitate dynamic events associated with gallbladder filling and emptying, we developed a cholescintigraphic technique in which the radionuclide99mTc-HIDA excreted in bile was externally measured by a gamma camera interfaced to a computer programmed for data processing. Changes in activity with time were measured over the liver, bile ducts, gallbladder, small intestine, and stomach. The first 60 min were used to detect activity filling the gallbladder. Cholecystokinin was then infused at 0.020 U/kg/min for 30 min to initiate gallbladder contraction, while monitoring the evacuation of radionuclide into the small intestine and/or stomach. The stomach region was defined by a99mTc-sulphur colloid swallow. With computer assistance, we were able to measure the rate at which the gallbladder filled, the fraction of liver activity that partitioned into the gallbladder instead of the duodenum, the rate of gallbladder emptying, and any gastric reflux. In 12 fasting, healthy subjects, three-fourths of the hepatic activity entered the gallbladder. After a 5 min time lag, gallbladder emptying commenced in response to the cholecystokinin, ejecting half its contents in 12 min, but still having a residual 25% after 30 min. Gallbladder evacuation was definitely slower in 6 patients with cholelithiasis, although filling appeared normal. One patient with gallstones underwent a repeat study after 4 mo on chenodeoxycholic acid therapy: Gallbladder filling, and especially emptying, deteriorated. Gastric reflux occurred only in 2 patients with gastroenterostomies who refluxed 2% of their gallbladder contents into the gastric remnant. Quantitative cholescintigraphy offers a new objective means to define gallbladder function and document bile reflux.