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KMID : 0378019860290040090
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New Medical Journal
1986 Volume.29 No. 4 p.90 ~ p.102
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Cholecystosongraphy Following Second Dose Non-Visualization of Gallbladder Surgical and Pathological Correlation
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Kim SE-KYUNG
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Abstract
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One hundred-thirty patients whose gallbladders failed to visualize after a second dose of oral cholecystographic contrast material underwent cholecystosonography. The interpretations of cholecystosonography were divided in four groups: Group I-one or more mobile echogenic shadowing opacities within the gallbladder; Group II-echogenic shadowing in the area of the gallbladder- fossa without visualization of the gallbladder lumen suggesting a small contracted gallbladder with or without stones; Group III-non-shadowing opacities within the gallbladder lumen; Group IV-normal.
The accuracy rate in diagnosing stones was: Group I-100%; Group 11-89%; Group 111-75%. Since all ninety-four Partients in these three groups werefound to have diseased gallbladders, placement in Groups I, II or III should be considered prime evidence of an abnormal gallbladder. Thirty-six of one hundred-thirty patients had a normal songram. Eight of 36 patients underwent surgery because of clinical symptoms and signs. All eight patients had diseased gallbladders and two of these had gallstones.
The false negativa rate of stone detection by cholecystosonography was 5.5% (2 of 36 patients) in group IV, but over all false negative to identify the cholelithiasis in this study was 1.5% (2 of 130 patients). Six of the remaining 28 patients were found to have non-visualization on second dose cholecystography due to other extrinsic and intrinsis cause.
The last twenty-two patients with normal findings of cholecystosonography following non-visualization after second dose oral cholecystogram are being followed. Such a high rate of normal cholecystosonography may occur probably because most of the oral cholecystograrn were done on an out-patient basis.
The over all acuracy rate of sonography in the operatively confirmed cases was E856. This study reveals that the cases of non-visualization of gallbladder on two consecutive oral cholecystography need to have cholecystosonography.
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