부산대학교 도서관

Recent literature in medical journals does not show any major role for scintigraphy in the evaluation of jaundice. A project was undertaken to test critically the role for scintigraphy in the detection, localization and quantification of partial obstruction of CBD using Tc-99m-IDA and the results are correlated with cholangiogram. After 4 to 5 hours of fast, each of 12 patients with documented CBD obstruction was given 3 to 8 mCi of Tc-99m-IDA and serial hepatobiliary images at 2 minute intervals were taken for 90 minutes using gamma camera and the data were collected on computer for quantitation. At 70 minutes 10 ng/kg of CCK-8 was infused over a 3 minute period (n=8). Liver excretion half time, GB ejection fraction (EF) and ejection rate (ER) were obtained. The results were compared with established values in normal subjects. The location of CBD obstruction was made from analogue images. Partial CBD obstruction was characterized in all but one by prolonged liver excretion half time, reduced GB EF and ER (less than 3.5%/min) and intrahepatic bile pooling with excellent CHD and CBD delineation proximal to obstruction thus aiding in the exact anatomic location which correlated well with cholangiogram. The degree of obstruction (ER) correlated well with dilitation of CBD on cholangiogram. These preliminary results show a promise for scintigraphy in the evaluation of CBD obstruction and offer a great potential for non-invasive quantitation of the degree of CBD obstruction.