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Morphine-augmented cholescintigraphy in acute cholecystitis. A satisfactory alternative to delayed imaging
A M Kistler1, H A Ziessman, D Gooch
1Division of Nuclear Medicine, National Naval Medical Center, Bethesda, Maryland 20814.
Clinical Nuclear Medicine
|June 1, 1991
Summary
Morphine-augmented cholescintigraphy is a sensitive tool for diagnosing acute cholecystitis, showing 93% sensitivity. However, specificity is limited by prolonged fasting and chronic cholecystitis.
Area of Science:
- Hepatobiliary imaging
- Diagnostic radiology
- Gastroenterology
Background:
- Acute cholecystitis diagnosis can be challenging.
- Conventional cholescintigraphy has limitations.
- Morphine augmentation is explored to improve gallbladder visualization.
Purpose of the Study:
- To evaluate the diagnostic utility of morphine-augmented cholescintigraphy.
- To determine the sensitivity and specificity of this technique for acute cholecystitis.
Main Methods:
- Retrospective review of 32 patients with suspected acute cholecystitis.
- Intravenous administration of 2 mg morphine sulfate if gallbladder failed to visualize by 30 minutes.
- Continued imaging for up to 60 minutes post-morphine administration.
Main Results:
- Sensitivity for acute cholecystitis detection was 93% (13/14).
- Specificity was 78% (14/18).
- False-positives (3/4) were associated with prolonged fasting and chronic cholecystitis.
Conclusions:
- Morphine-augmented cholescintigraphy offers high sensitivity for acute cholecystitis.
- Specificity is affected by prolonged fasting and chronic cholecystitis, similar to conventional methods.
- The technique demonstrates diagnostic equivalence to longer imaging protocols.