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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Got radiology nuclear medicine results. What are the findings?

Answered by
Dr.
Dr. Manoranjan Chowhan

Radiologist, Nuclear Medicine

Practicing since :1991

Answered : 103 Questions

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Posted on Tue, 29 Jan 2013 in X-ray, Lab tests and Scans
Question: NUCLEAR MEDICINE HEPATOBILIARY SCAN
COMPARISON: Right upper quadrant ultrasound dated 23 May 2012.
F TECHNIQUE: Imaging of the gallbladder and liver after 4.98 mCi of
technetium 99m Choletec was administered intravenously. There were 1.68 mg of CCK also administered intravenously.
FINDINGS:
There is symmetric uptake within the liver. The gallbladder is identified at
minute three. Bowel activity is identified at six minutes. No filling defect is identified within the gallbladder. The gallbladder ejection fraction is
80%.
IMPRESSION:
NORMAL HEPATOBILIARY SCAN

RIGHT OPPER QUADRANT ULTRASOUND
COMPARISON: Abdominal ultrasound, 26 April 2012.
FINDINGS: Pancreas head and body are unremarkable. The tail is not seen.
There
is increased echogenicity of the liver. The gallbladder wall measures 0.2
em.
No filling defect is identified within the gallbladder. Common duct
measures
0. 5 em.
The right kidney has a length of 10.4 em and demonstrates a normal
sonographic
appearance.
IMPRESSION:
1. HEPATIC STEATOSIS.
2. NO EVIDENCE OF CHOLELITHIASIS OR ACUTE CHOLECYSTITIS.

-------------
Reason for Order:
Status: Complete
MRI,ABDOMEN
09-May-2012 07:32:00
NO BRIEF COMMENT
Pt with hx of abdominal pain. abdominal u/s normal. I spoke with
radiologist and
he recommended
She is having ongoing abd
0000
11-Jun-2012 14:18:00
13-Jun-2012 04:33:00
sx. Please eval

MRI ABDOMEN, WITHOUT CONTRAST, WITH MRCP SEQUENCE
F
COMPARISON: Nuclear medicine HIDA scan dated 05/24/2012 and right upper
quadrant abdominal ultrasound dated 05/23/2012.
TECHNIQUE: Multiplanar, multisequence MRI images of the abdomen were
acquired on a 1.5 Tesla scanner with MRCP sequences.
FINDINGS: The visualized osseous structures are intact with normal marrow
signal intensity. No abdominal ascites is identified. No
pathologically-enlarged lymph nodes are identified in the abdomen.
Visualized bowel and mesentery are unremarkable. Visualized portions of the spinal
cord demonstrate normal signal intensity. Visualized vascular structures
demonstrate normal noncontrast appearance. No aneurysmal dilatation of the abdominal aorta. The liver, pancreas, spleen, bilateral adrenal glands, and left kidney arenormal in noncontrast appearance. There is a tiny 4.5 mm cystic lesion
off the posteromedial margin of the right kidney, likely representing a benign
renal cyst. The visualized portions of the gallbladder demonstrate normal signal
intensity or and morphology. No evidence for intraluminal filling defects to suggest
presence of gallstones. No adjacent pericholecystic inflammatory change fluid. uniform The cystic duct measures approximately 4.5 mm in diameter. It is
in appearance, without evidence for strictures or dilatations. The common
bile No duct measures approximately 4.5 mm in diameter and is uniform in caliber
throughout its visualized course with smooth tapering near the ampulla.
evidence for intraluminal filling defects. No intrahepatic or
extrahepatic biliary ductal dilatation. No evidence for sequential areas of focal
stricturing and dilatation.
IMPRESSION:
1. UNRE~~RKABLE NONCONTRAST MRI EVALUATION OF THE ABDOMEN AND BILIARY DUCTAL SYSTEM WITH UNREMARKABLE MRCP. NO INTRALUMINAL FILLING DEFECTS OR AREAS OF FOCAL DILATATION AND STRICTURING.

t: MSG


Please review radiology nuclear medicine results. what is an acceptable gallbladder ejection fraction and at what point is a gallbladder removal appropriate?
doctor
Answered by Dr. Manoranjan Chowhan 3 hours later
Hi,

Thanks for the query.

I went through the reports and following are my comments:

1. It appears that the Gall bladder (GB) is normally visualised. There is neither gall stone nor any feature suggestive of acute cholecystitis - so there is no indication for gall bladder surgery currently.

2. The GB EF is 80% - that lies within normal limit. The reference value varies between 50 to 80%.

3. Since Inj. CCK was administered and the GB EF lies in normal range - currently there is no indication to go under the knife.

4. In future, a surgery might be needed if you develop fresh symptoms, ultrasound sound reveal gall stones; features of acute inflammation along with fall in GB functions below 30%.

Let me know if you need further clarifications.

Regards


Above answer was peer-reviewed by : Dr. Prasad
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