Rapid evaluation of acute abdominal pain by hepatobiliary scanning

One hundred eight-six patients with suspected acute cholecystitis (AC) underwent radionuclide hepatobiliary imaging with technetium Tc 99m iprofenin to assess the ability of this tracer to detect AC. After intravenous injection of 5 to 10 mCi of this agent, 500,000 count anterior images were obtained at ten-minute intervals for 60 minutes. An abnormal hepatobiliary scan (HBS) diagnostic of AC was defined as one in which the common bile duct, but not the gallbladder, visualized within one hour of tracer administration. In this series, the sensitivity and specificity for HBS in the detection of AC were 97% and 87%, respectively. The hepatobiliary scan should be the procedure of choice for the rapid detection of AC. It is simple, rapid, and safe to perform, enabling a diagnosis to be established within one hour.