BACKGROUND Hepatobiliary scintigraphy(HBS)is a useful diagnostic imaging technique that uses radiotracers to evaluate the function of the gallbladder(GB)and biliary system.In segmented GB,some HBS images reveal a disc...BACKGROUND Hepatobiliary scintigraphy(HBS)is a useful diagnostic imaging technique that uses radiotracers to evaluate the function of the gallbladder(GB)and biliary system.In segmented GB,some HBS images reveal a discordant GB boundary as compared to anatomical images.AIM To evaluate the characteristics of HBS in segmented GB and determine the clinical relevance according to HBS characteristics.METHODS A total of 268 patients with chronic cholecystitis,gallstones,or biliary colic symptoms who underwent HBS between 2011 and 2020 were enrolled.Segmented GB was defined as segmental luminal narrowing of the GB body on computed tomography(CT)or magnetic resonance(MR)images,and HBS was examined 1 mo before or after CT or MR.Segmented GB was classified into 3 types based on the filling and emptying patterns of the proximal and distal segments according to the characteristics of HBS images,and GB ejection fraction(GBEF)was identified:Type 1 was defined as a normal filling and emptying pattern;Type 2 was defined as an emptying defect on the distal segment;and Type 3 was defined as a filling defect in the distal segment.RESULTS Segmented GB accounted for 63 cases(23.5%),including 36 patients(57.1%)with Type 1,18 patients(28.6%)with Type 2,and 9 patients(14.3%)with Type 3 emptying pattern.Thus,approximately 43%of HBS images showed a discordant pattern as compared to anatomical imaging of segmented GB.Although there were no significant differences in clinical symptoms,rate of cholecystectomy,or pathological findings based on the type,most gallstones occurred in the distal segment.Reported GBEF was 62.50%±24.79%for Type 1,75.89%±17.21%for Type 2,and 88.56%±7.20%for Type 3.Type 1 showed no difference in reported GBEF compared to the non-segmented GB group(62.50%±24.79%vs 67.40%±21.78%).In contrast,the reported GBEF was higher in Types 2 and 3 with defective emptying and filling when compared to Type 1(80.11%±15.70%vs 62.57%±24.79%;P=0.001).CONCLUSION In segmented GB,discordance in the filling patterns detected by HBS and anatomical imaging could lead to misinterpretation of GBEF.For this reason,clinicians should be cautious when interpreting HBS results in patients with segmented GB.展开更多
AIM: To analyze gallbladder contractility in patients with black pigment stones (BPSs) and to compare this with patients with cholesterol stones (CSs) and healthy volunteers. METHODS: The pattern of bile evacuation fr...AIM: To analyze gallbladder contractility in patients with black pigment stones (BPSs) and to compare this with patients with cholesterol stones (CSs) and healthy volunteers. METHODS: The pattern of bile evacuation from the gallbladder was quantified by computer cholescintigraphy in 28 normal subjects, 22 patients with CSs and 14 with BPSs. The parameters of gallbladder contractility included ejection period (EP), ejection fraction (EF) and ejection rate (ER). RESULTS: A significantly shorter EP was observed in patients with BPSs in comparison to those with CSs (t = 2.4, P < 0.05). EF in BPS patients significantly decreased in comparison to that in CS and normal subjects (t = 6.4, P < 0.0001; t = 2.1, P < 0.05). EF in CS patients also significantly decreased in comparison to that in normal subjects (t = -3.0, P < 0.005). Consequently, ER in patients with BPSs and CSs was significantly smaller than that in normal subjects (t = 3.1, P < 0.005; t = -3.5, P < 0.001). Moreover, in cases where postprandial reflux of a radioisotope into the common hepatic duct from the gallbladder was observed, EF and ER of either CS or BPS patients showed a significant reduction. CONCLUSION: Bile evacuation from the gallbladder is reduced in patients with BPSs, in comparison to those with CSs and to healthy volunteers. Bile stagnation due to impaired gallbladder kinetics seems to be one of the predisposing factors for the development of BPSs.展开更多
AIM: To ultrasonographicaly evaluate the acute effects of smoking on gallbladder contraction and refilling in chronic smokers and nonsmokers.METHODS: Fifteen chronic smokers (21-30 years old) and fifteen nonsmokers (2...AIM: To ultrasonographicaly evaluate the acute effects of smoking on gallbladder contraction and refilling in chronic smokers and nonsmokers.METHODS: Fifteen chronic smokers (21-30 years old) and fifteen nonsmokers (21-35 years old) participated in this study. Chronic smokers were selected among the volunteers who had been smoking for at least 5 years and 10 cigarettes per day (mean 17.5/d). Examinations were performed in two separate days. In the fi rst day, basal gallbladder (GB) volumes of volunteers were measured after 8-h fasting. After the examinations, participants had a meal containing at least 30-40 gram fat. Gallbladder volume was assessed at 5, 15, 30, 60, 120 and 180 min after the meal. In the second day, participants smoked 2 cigarettes after 8-h fasting. Then, they had the same meal, and gallbladder measurements were repeated at the same time points. Same procedures were applied to both groups. RESULTS: The mean starving GB volumes were 23.3 ± 3.3 mL in the fi rst day, 21.9 ± 3.0 mL in the second day in nonsmoker group and 18.3 ± 3.0 mL in the fi rst day, 19.5 ± 2.8 mL in second day in smoker group. There was no significant difference between starving GB volumes. We did not fi nd any signifi cant difference between the GB volumes measured at 5, 15, 30, 60, 120 and 180 min in the fi rst and second days in nonsmoker group. In smokers, post cigarette GB volume was found significantly higher at 5, 15 and 30 min which corresponded to GB contraction phase (P < 0.05). Control GB volume measurements were not signifi cantly different between the two groups. Post-smoking GB volumes were also not signifi cantly different between the two groups.CONCLUSION: Smoking prolongs the maximal GB emptying time both in smokers and in nonsmokers though it is not signifi cant. It delays GB contraction inchronic smokers and causes a signifi cant decrease in GB emptying volume. Smoking causes no signifi cant delay in GB refi lling in both smokers and nonsmokers. These effects of smoking observed in acute phase result in bile stasis in GB. Bile stasis is the underlying cause of most GB disorders in chronic process.展开更多
Gastric and gallbladder emptying in 113 patients with functional dyspepsia (FD) were evaluated by real-time ultrasonography (RUS) after a liquid-fat meal by the patients, and compared with 15 healthy volunteers. The r...Gastric and gallbladder emptying in 113 patients with functional dyspepsia (FD) were evaluated by real-time ultrasonography (RUS) after a liquid-fat meal by the patients, and compared with 15 healthy volunteers. The results showed that in FD group 69 patients (61. 06%) had delayed gastric emptying,and 28 patients (24.77%) had gallbladder hypokinesia. Among them both delayed gastric ernptying and gallbladder hypokinesia were found in 11 patients (9.7%), 44 patients (38.93%)had normal gastric emptying and 85 patients (75.22%) had normal gallbladder emptying.展开更多
基金reviewed and approved by the Jeonbuk National University Hospital Institutional Review Board,No.2021-07-005.
文摘BACKGROUND Hepatobiliary scintigraphy(HBS)is a useful diagnostic imaging technique that uses radiotracers to evaluate the function of the gallbladder(GB)and biliary system.In segmented GB,some HBS images reveal a discordant GB boundary as compared to anatomical images.AIM To evaluate the characteristics of HBS in segmented GB and determine the clinical relevance according to HBS characteristics.METHODS A total of 268 patients with chronic cholecystitis,gallstones,or biliary colic symptoms who underwent HBS between 2011 and 2020 were enrolled.Segmented GB was defined as segmental luminal narrowing of the GB body on computed tomography(CT)or magnetic resonance(MR)images,and HBS was examined 1 mo before or after CT or MR.Segmented GB was classified into 3 types based on the filling and emptying patterns of the proximal and distal segments according to the characteristics of HBS images,and GB ejection fraction(GBEF)was identified:Type 1 was defined as a normal filling and emptying pattern;Type 2 was defined as an emptying defect on the distal segment;and Type 3 was defined as a filling defect in the distal segment.RESULTS Segmented GB accounted for 63 cases(23.5%),including 36 patients(57.1%)with Type 1,18 patients(28.6%)with Type 2,and 9 patients(14.3%)with Type 3 emptying pattern.Thus,approximately 43%of HBS images showed a discordant pattern as compared to anatomical imaging of segmented GB.Although there were no significant differences in clinical symptoms,rate of cholecystectomy,or pathological findings based on the type,most gallstones occurred in the distal segment.Reported GBEF was 62.50%±24.79%for Type 1,75.89%±17.21%for Type 2,and 88.56%±7.20%for Type 3.Type 1 showed no difference in reported GBEF compared to the non-segmented GB group(62.50%±24.79%vs 67.40%±21.78%).In contrast,the reported GBEF was higher in Types 2 and 3 with defective emptying and filling when compared to Type 1(80.11%±15.70%vs 62.57%±24.79%;P=0.001).CONCLUSION In segmented GB,discordance in the filling patterns detected by HBS and anatomical imaging could lead to misinterpretation of GBEF.For this reason,clinicians should be cautious when interpreting HBS results in patients with segmented GB.
文摘AIM: To analyze gallbladder contractility in patients with black pigment stones (BPSs) and to compare this with patients with cholesterol stones (CSs) and healthy volunteers. METHODS: The pattern of bile evacuation from the gallbladder was quantified by computer cholescintigraphy in 28 normal subjects, 22 patients with CSs and 14 with BPSs. The parameters of gallbladder contractility included ejection period (EP), ejection fraction (EF) and ejection rate (ER). RESULTS: A significantly shorter EP was observed in patients with BPSs in comparison to those with CSs (t = 2.4, P < 0.05). EF in BPS patients significantly decreased in comparison to that in CS and normal subjects (t = 6.4, P < 0.0001; t = 2.1, P < 0.05). EF in CS patients also significantly decreased in comparison to that in normal subjects (t = -3.0, P < 0.005). Consequently, ER in patients with BPSs and CSs was significantly smaller than that in normal subjects (t = 3.1, P < 0.005; t = -3.5, P < 0.001). Moreover, in cases where postprandial reflux of a radioisotope into the common hepatic duct from the gallbladder was observed, EF and ER of either CS or BPS patients showed a significant reduction. CONCLUSION: Bile evacuation from the gallbladder is reduced in patients with BPSs, in comparison to those with CSs and to healthy volunteers. Bile stagnation due to impaired gallbladder kinetics seems to be one of the predisposing factors for the development of BPSs.
文摘AIM: To ultrasonographicaly evaluate the acute effects of smoking on gallbladder contraction and refilling in chronic smokers and nonsmokers.METHODS: Fifteen chronic smokers (21-30 years old) and fifteen nonsmokers (21-35 years old) participated in this study. Chronic smokers were selected among the volunteers who had been smoking for at least 5 years and 10 cigarettes per day (mean 17.5/d). Examinations were performed in two separate days. In the fi rst day, basal gallbladder (GB) volumes of volunteers were measured after 8-h fasting. After the examinations, participants had a meal containing at least 30-40 gram fat. Gallbladder volume was assessed at 5, 15, 30, 60, 120 and 180 min after the meal. In the second day, participants smoked 2 cigarettes after 8-h fasting. Then, they had the same meal, and gallbladder measurements were repeated at the same time points. Same procedures were applied to both groups. RESULTS: The mean starving GB volumes were 23.3 ± 3.3 mL in the fi rst day, 21.9 ± 3.0 mL in the second day in nonsmoker group and 18.3 ± 3.0 mL in the fi rst day, 19.5 ± 2.8 mL in second day in smoker group. There was no significant difference between starving GB volumes. We did not fi nd any signifi cant difference between the GB volumes measured at 5, 15, 30, 60, 120 and 180 min in the fi rst and second days in nonsmoker group. In smokers, post cigarette GB volume was found significantly higher at 5, 15 and 30 min which corresponded to GB contraction phase (P < 0.05). Control GB volume measurements were not signifi cantly different between the two groups. Post-smoking GB volumes were also not signifi cantly different between the two groups.CONCLUSION: Smoking prolongs the maximal GB emptying time both in smokers and in nonsmokers though it is not signifi cant. It delays GB contraction inchronic smokers and causes a signifi cant decrease in GB emptying volume. Smoking causes no signifi cant delay in GB refi lling in both smokers and nonsmokers. These effects of smoking observed in acute phase result in bile stasis in GB. Bile stasis is the underlying cause of most GB disorders in chronic process.
文摘Gastric and gallbladder emptying in 113 patients with functional dyspepsia (FD) were evaluated by real-time ultrasonography (RUS) after a liquid-fat meal by the patients, and compared with 15 healthy volunteers. The results showed that in FD group 69 patients (61. 06%) had delayed gastric emptying,and 28 patients (24.77%) had gallbladder hypokinesia. Among them both delayed gastric ernptying and gallbladder hypokinesia were found in 11 patients (9.7%), 44 patients (38.93%)had normal gastric emptying and 85 patients (75.22%) had normal gallbladder emptying.
