The value of 99mTc-cholescintigraphy as compared with infusion cholecystography for diagnosing acute cholecystitis

A prospective comparative study was made of 99mTc-HIDA cholescintigraphy and 24-h infusion cholecystography for the diagnosis of acute cholecystitis. The material comprised 50 patients. Non-visualization of the gallbladder was regarded as a positive result and as indicative of acute cholecystitis. The final diagnoses were made at operation (36 patients), by additional examinations (9 patients), by a typical clinical course (3 patients), and at autopsy (2 patients). The predictive value of a positive and a negative cholescintigraphy was 92.6% and 95.7%, respectively. The predictive value of a positive and a negative infusion cholecystography was 78.6% and 81.8%, respectively. There was no statistically significant difference between the results of the two tests. The 99mTc-HIDA cholescintigraphy was easier and quicker to perform than the cholecystography, and likewise the scintigrams were easier to assess than the infusion cholecystograms. The diagnostic certainty of cholescintigraphy was found to be high, and the test is recommended in patients suspected of having acute cholecystitis.