John Joseph Schmitz MD, Presenter: Nothing to Disclose

Grant D. Schmit MD, Abstract Co-Author: Nothing to Disclose

Duane David Meixner, Abstract Co-Author: Nothing to Disclose

John Marshall Knudsen MD, Abstract Co-Author: Nothing to Disclose

Matthew Raymond Callstrom MD, PhD, Abstract Co-Author: Research Grant, Endocare, Inc Research Grant, Siemens AG

Douglas Collins MD, Abstract Co-Author: Nothing to Disclose

Rickey Carter PhD, Abstract Co-Author: Nothing to Disclose

To compare three-dimensional ultrasound (3D-US) with cholescintigraphy for the assessment of gallbladder contractility.

Gallbladder contractility was simultaneously evaluated with cholescintigraphy and 3-D ultrasound in 13 patients with suspected gallbladder disease, Patients were injected with a standard dose of technetium-99m disofenin and imaged under a planar gamma camera for 60 minutes. At 60-90 minutes, an infusion of Sincalide (a cholecystokinetic drug) was administered at a standardized dose and rate. Following Sincalide infusion, cholescintigraphic images were obtained for an additional 60 minutes. At the initiation of the Sincalide infusion and every 10 minutes afterwards for 60 minutes, three-dimensional sonographic measurements of gallbladder volume were also obtained. The results were analyzed for statistical significance.

The mean gallbladder ejection fraction was 79% (range, 18% to 97%) according to HIDA and 76% (range, 12% to 100%) according to 3D-US . Using the paired measurements, the mean difference between the 3D-US relative to HIDA was -2% (95% CI: -8% to 4%). The estimated ejection fractions using HIDA and 3D-US were strongly correlated (r=0.92, p<0.0001 ).

In our study, 3-D sonography was comparable to scintigraphy for evaluation of gallbladder contractility. Sonographic evaluation of contractility requires less time than scintigraphic evaluation, and does not expose patients and healthcare providers to radiation. Cholescintigraphy is widely accepted as the gold-standard for the evaluation of gallbladder contractility and ejection fractions. Disadvantages of cholescintigraphy include radiation exposure, duration of the exam, lack of portability of examination equipment, and lack of anatomic detail. Ultrasound examination of the gallbladder has none of these detractors. Additionally, ultrasound is already routinely used in evaluation of the gallbladder. Adding assessment of contractility in the proper clinical cases has potential to greatly expedite the delivery of appropriate care.

Sonography can provide an affordable, portable, reliable, and radiation-free alternative for evaluation of gallbladder contractility that can be performed during the initial patient evaluation.

Schmitz, J, Schmit, G, Meixner, D, Knudsen, J, Callstrom, M, Collins, D, Carter, R, Simultaneous Comparison of Gallbladder Ejection Fractions Measured by 3D Ultrasound and Cholescintigraphy.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034394.html