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  • Title: Scintigraphic findings in acute gangrenous cholecystitis.
    Author: Shih WJ, Domstad PA, Kenady DE, DeLand FH.
    Journal: Clin Nucl Med; 1987 Sep; 12(9):717-20. PubMed ID: 3665314.
    Abstract:
    Nine patients who had surgically proven acute gangrenous cholecystitis and Tc-99m DISIDA scintigrams were reviewed retrospectively. Three types of scintigraphic findings were presented: 1) nonvisualization of the gallbladder, three cases; 2) nonvisualization of the gallbladder plus a rim sign, two cases; and 3) nonvisualization of the gallbladder plus an enlarged photon deficient area corresponding to the gallbladder fossa, four cases. A rim sign or an enlarged gallbladder fossa reflect the direct spread of inflammation from the gallbladder into the liver, causing impaired hepatocyte function. An enlarged gallbladder fossa may represent a later stage of a rim sign. Presumably tracer excretion by hepatocytes is affected initially by the inflammatory process, followed by impairment of tracer concentrating ability. Since the gallbladder may be suspended occasionally by a mesentery and not in contact with the liver, the secondary signs may be absent in acute gangrenous cholecystitis.
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