Chronic cholecystitis other imaging findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2], Furqan M M. M.B.B.S[3]

HIDA cholescintigraphy is the most sensitive and accurate modality for the diagnosis of chronic cholecystitis. HIDA cholescintigraphy findings for chronic cholecystitis include delayed gallbladder isotope accumulation, irregular gallbladder filling, or photopenic areas and septations.

HIDA cholescintigraphy findings for chronic cholecystitis include:

• Delayed gallbladder isotope accumulation
• Irregular gallbladder filling or
• Photopenic areas and septations

A gallbladder ejection fraction of less than 35% after the administration of cholecystokinin indicates the presence of the chronic calculus or chronic acalculous cholecystitis.

• Chronic cholecystitis may be diagnosed by hepatobiliary scintigraphy using technetium-99m.
  • The release capacity (ejection fraction) of the gall bladder may also be estimated using this technique.
  • A decreased in the capacity of the gallbladder to release bile is understood to be associated with chronic cholecystitis.
  • However, cholecystitis is not the most common cause of right upper quadrant pain, initial evaluation must focus on narrowing down the exact diagnosis.^[1][2]
• HIDA cholescintigraphy in chronic cholecystitis may show:
  • A delay in the collection of isotope inside the gallbladder
  • Abnormal filling of the gallbladder and
  • Septations
• A decrease in the ejection fraction of the gallbladder to 35% following cholecystokinin is helpful in the diagnosis of calculus or acalculous cholecystitis of chronic type.^[3]

The HIDA cholescintigraphy based diagnostic criteria from multiple studies for acalculous cholecystits is as follows.^[4]

Diagnosis: RC alone or RC and MC.

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