Falsely negative cholecystography and cholangiography

Kolodny, Marvin; Colker, Joel L.; Callahan, Edward W.; Baker, Wendy

doi:10.1007/bf02232976

Cited by 4 publications

(1 citation statement)

References 5 publications

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“…The relatively high incidence of nonopacification leads to an overall accuracy of 90% for the technique [13] in subject populations with clinical indications for examination. A 7% false negative rate for X-ray cholecystography has been reported [14]. Sector ultrasound scanning appears superior in primary gallbladder visualization and stone detection.…”

Section: Discussionmentioning

confidence: 99%

Population survey: Ultrasonic cholecystography

Birnholz

1982

Gastrointest Radiol

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Anatomic localization and diagnostic inspection of the gallbladder are achieved in 30-60 s with the use of a recently developed electronic sector scanning ultrasound imaging system. Approximately 98% visualization is achieved without patient preparation or selection. In a prototype survey of 766 patients, cholelithiasis was detected in 43 of 130 subjects with right upper quadrant pain syndromes and in 64 of 581 asymptomatic subjects.Exact prevalence rates for cholelithiasis are unknown, although a relatively high rate may be anticipated from extant pathologic [1-3] and radiologic [3,4] data. Detection of cholelithiasis is important for individual and general health care planning because of the possible complications of this abnormality, the availability of surgical treatment, and the potential for nonsurgical, chemotherapeutic dissolution of stones [5]. A decade ago, Ingelfinger [6] estimated that some 15 million Americans had gallstones and would account for some half million hospital admissions with a half billion dollars in surgery-related costs. Precise determination of true prevalence rates correlated with geographical, familial, ethnic, dietary, and other factors might provide insight for prevention schemes.Radiographic oral cholecystography is the present diagnostic standard for detecting cholelithiasis, although the method involves ionizing radiation exposure and contrast agent use and has a relatively high rate of study failure because of "nonopacification." This report describes a noninvasive technique for doc- Address reprint requests to:umenting cholelithiasis that may be applied in mass screening situations. MethodsThe study population consisted of 766 adult subjects referred for ultrasound evaluation of the chest, abdomen, retroperitoneum, or pelvis. There was no required pre-examination restriction of food or fluid intake, nor limitation as to time of day for the examination. Only the first examination was recorded in subjects who were referred for more than one ultrasound study.Examination was performed with a commercial electronic sector scanning (phased array) system (Varian V-3000, Varian Associates, Palo Alto, California) having the following performance features: 85 ~ arc 21 cm depth field of view, 1 mm axial and 4 mm average lateral resolution at 2.25 mHz center frequency operation, wide dynamic range (gray scale) display and 30 frames per second imaging rate. Subjects were studied in a supine position with a thin layer of mineral oil as the skin-probe coupling agent.The gallbladder was located by transhepatic scanning. The probe was placed in an intercostal space in the mid to anterior axillary line. The right upper quadrant was "searched" by continuous observation during probe angulation and translation. When the gallbladder was identified, probe position was adjusted for viewing the entire gallbladder along its orthogonal long and short axes. During this process, the porta hepatis (portal vein and common duct), hepatic parenchyma, and right kidney were observed. Additional views of the ga...

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Section: Discussionmentioning

confidence: 99%

Population survey: Ultrasonic cholecystography

Birnholz

1982

Gastrointest Radiol

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Detection of gallbladder disease in patients with normal oral cholecystograms

Foss

Laing

1977

Digest Dis Sci

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An endoscopic biliary drainage technique was used in the study of 70 patients. All had histories suggestive of gallbladder disease but with normal oral cholecystograms. Of the 29 patients with abnormal drainage studies, 26 had cholecystectomy with all specimens showing cholecystitis, and cholelithiasis was seen in 46%. Five of the 41 patients with normal drainages underwent cholecystectomy, with no abnormality noted in any surgical specimen. Significant differences were seen when the mean WBC count, frequency of leukocytosis, and back pain were compared between the normal and abnormal drainage groups. Biliary drainage is a useful supplemental test when a false-negative oral cholecystogram is suspected.

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Endoscopic biliary drainage for detection of gallbladder disease

Reisberg

Mabee

1979

Gastrointestinal Endoscopy

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Falsely negative cholecystography and cholangiography

Cited by 4 publications

References 5 publications

Population survey: Ultrasonic cholecystography

Population survey: Ultrasonic cholecystography

Detection of gallbladder disease in patients with normal oral cholecystograms

Endoscopic biliary drainage for detection of gallbladder disease

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