Normal Values of Gallbladder Ejection Fraction
Using 99mTc-sestamibi Scintigraphy after a Fatty Meal Formula
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Vahid Reza Dabbagh Kakhki1, Seyed Rasoul Zakavi1, Yasmin
Davoudi2
1) Department of Nuclear Medicine.
2) Department of Radiology, Imam Reza Hospital, Mashhad University
of Medical Sciences, Mashhad, Iran
Abstract
Background & Aims. Sincalide, in conjunction
with cholescintigraphy, is necessary for the diagnosis of chronic
acalculous cholecystitis. However sincalide is not widely available.
This study investigates the use of a commercially available formula
as an inexpensive alternative to sincalide, containing a sufficient
and known amount of fat to cause gallbladder contraction, and
to determine normal gallbladder ejection fraction (GBEF) values.
Methods. We studied 36 patients aged 51.7±10.9
years with body mass index 26.7± 5.2 who were referred for 99mTc-sestamibi
myocardial perfusion imaging. They did not have any abdominal
symptoms, or history of abdominal disease and were not taking
any medication known to affect the biliary tract. All were prescreened
with a hepatobiliary ultrasonography to exclude any abnormality.
After 6 hours fasting, 20 mCi of 99mTc-sestamibi was injected
intravenously at rest and 90 minutes later the subjects ingested
a test meal (10 g fat). GBEF was calculated at 30 and 60 minutes
after fatty meal ingestion.
Results. GBEF at 30 minutes and at 60 minutes after fatty
meal ingestion were 69.54±21.04% and 84.26±11.41%, respectively.
GBEF did not differ significantly between men and women. There
was no statistically significant correlation between BMI and GBEF.
No significant difference was noticed in GBEF between obese, overweight
and normal weight patient groups.
Conclusion. Lower limit of normal GBEF values was 27.46%
at 30 min and 61.44% at 60 min using a standard fatty meal. It
is possible to report the results of a GBEF measurement after
fatty meal in terms of the percentile rank, compared with subjects
without biliary disease.
Key words
Gallbladder ejection fraction - chronic acalculous cholecystitis
- fatty meal - cholescintigraphy
