Gallbladder motility disorders estimated by non-invasive methods.

BACKGROUND/AIMS: The aim is to compare the radionuclide (DC) and ultrasonographic (US) method in the assessment of gallbladder (GB) motility. METHODOLOGY: The study was performed in 15 controls (C), 10 patients with acute cholecystitis (AC), 20 patients with chronic acalculous cholecystitis (CAC), 26 patients with chronic cholecystitis with calculosis (CCC) as well as in 15 patients with GB dyskinesia (D). GB emptying period (EP), ejection fraction (EF) and ejection rate (ER) were estimated with dynamic cholescintigraphy (DC) and US. RESULTS: The DC and US finding in the patients with AC was typical in all the patients, i.e. GB was not visualized at all on DC, while on US, stone was visible in the cystic duct. There were significant differences (p<0.05) between the EF and ER values obtained between C and the three groups of patients CAC, CCC and D, using both methods. However, there were no significant differences in EF, EP and ER values among CAC, CCC and D (p>0.05). There was also high correlation between the results obtained with both methods in all the groups of patients studied. CONCLUSIONS: The results obtained by both methods are valuable for the assessment of GB motility. Although there are no significant differences and there is a high correlation between the values, radionuclide method is more precise, because it can register motility continuously.

Possible role of the scintigraphic estimation of the relative liver perfusion in the diagnosis and therapy of liver carcinomas.

BACKGROUND: The aim of the study is evaluation of the possible role of the scintigraphic estimation of the relative liver perfusion in diagnosis and the choice of treatment of liver carcinomas. MATERIAL AND METHODS: Hepatic perfusion index was obtained by dynamic scintigraphy in 126 patients. RESULTS: In the control group values did not differ from the value in the patients with benign tumors (p > 0.05). However, in hepatocellular carcinoma and liver metastases of different tumors, HPI values were significantly decreased in comparison to controls and benign tumors (p < 0.01), but they didn't differ between themselves (p > 0.05). The values were especially low in the patients with malignant diseases in the liver accosciated with vascular disturbances in the portal system. CONCLUSION: HRA could be easily done during the different conventional nuclear medicine methods. It can be an useful method for the assessment of different degrees of hemodynamic alterations in portal system, for differential diagnosis of benign and malignant liver tumors, as well as for assessment of the liver tissue and tumor perfusion, which might be helpful in the decision making for the undertaking of intraarterial (radionuclide, chemotherapy etc.) therapy.

Detection of gastrointestinal and abdominal infections by 99mTc-antigranulocyte antibodies.

BACKGROUND/AIMS: The aim of the study was detection of abdominal infections by 99mTc- antigranulocyte antibodies. METHODOLOGY: Total of 36 patients with clinical suspicion on abdominal or gastrointestinal infections was investigated. RESULTS: There were 23 true positive (TP) findings (one pulmonary abscess, 2 subhepatic abscesses after surgery, 2 perianal fistula, 2 chronic and 4 acute appendicitis, 5 abdominal and 3 pelvic abscesses, 3 M. Crohn, one ulcerative colitis), 9 true negative (TN) (3 tumors of the coecum, 2 tumors of papilla Wateri, 2 gastric carcinoma, 2 colon carcinoma), and 4 false negative (FN) (2 abscesses subphrenic and 2 enterocolic fistula). False positive (FP) findings were not observed. The smallest lesion found was 19x18 mm. SPECT increased the number of TP findings from 17 to 23. Fifteen of 23 infectious of inflammatory lesions could be detected in the early scan. Sensitivity was 85%, specificity 100%, positive predictive value 100%, negative predictive value 69% and accuracy 89%. CONCLUSION: According to the present results, scintigraphy with 99mTc antigranulocyte antibodies is a useful method for detection and assessment of exact localization abdominal infections, which is very important for the prompt and appropriate therapy.

Color Doppler sonography and angioscintigraphy in hepatic Hodgkin's lymphoma.

AIM: To estimate the characteristics of Color Doppler findings and the results of hepatic radionuclide angiography (HRA) in secondary Hodgkin's hepatic lymphoma. METHODS: The research included patients with a diagnosis of Hodgkin's lymphoma with metastatic focal lesions in the liver and controls. Morphologic characteristics of focal liver lesions and hemodynamic parameters were examined by pulsed and Color Doppler in the portal, hepatic and splenic veins were examined. Hepatic perfusion index (HPI) estimated by HRA was calculated. RESULTS: In the majority of patients, hepatomegaly was observed. Lesions were mostly hypoechoic and mixed, solitary or multiple. Some of the patients presented with dilated splenic veins and hepatofugal blood flow. A pulse wave was registered in the centre and at the margins of lymphoma. The average velocity of the pulse wave was higher at the margins (P > 0.05). A continuous venous wave was found only at the margins of lymphoma. There was no linear correlation between lymphoma size and velocity of pulse and continuous wave (r = 390, P < 0.01). HPI was significantly lower in patients with lymphomas than in controls (P < 0.05), pointing out increased arterial perfusion in comparison to portal perfusion. CONCLUSION: Color Doppler ultrasonography is a sensitive method for the detection of neovascularization in Hodgkin's hepatic lymphoma and estimation of its intensity. Hepatic radionuclide angiography can additionally help in the assessment of vascularisation of liver lesions.