Comparison of intravenous radionuclide cholescintigraphy and endoscopic retrograde cholangiography in the diagnosis of intrahepatic gall-stones

Abstract

I.v. radionuclide cholescintigraphy using 99Tcm-pyridoxylideneglutamate (Tc-99m-PG) was compared with endoscopic retrograde cholangiography (ERC) as a test for the preoperative detection of intrahepatic gallstones. Sixty-three patients, 42 of whom were clinically jaundiced, were studied and 27 of these had intrahepatic gallstones. Cholescintigraphy correctly predicted stones in all but 5 of these patients (false negative 19%), while ERC failed to show intrahepatic stones in 7 patients (false negative 26%). In the 36 patients found to have no intrahepatic stones, cholescintigraphy was incorrect in 6 patients (false positive 17%) and ERC incorrect in 2 (false positive 6%). Cholescintigraphy is at least as successful as ERC in predicting intrahepatic gallstones and is cheaper and less invasive. In populations where intrahepatic gallstones are common, it is likely to prove valuable as a preoperative screening test.