How often do false results occur from HIDA/DISIDA scanning in the evaluation of cholecystitis?

Updated: Jan 18, 2017
  • Author: Peter A D Steel, MBBS, MA; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

False-negative results (filling in 30 min) are found in 0.5% of studies, and filling between 30-60 minutes is associated with false-negative rates of 15-20%.

False-positive results (10-20%) occur when the gallbladder is not visualized despite a nonobstructed cystic duct. Causes include fasting patients receiving total parenteral nutrition; severe liver disease, which leads to abnormal uptake of the tracer; cystic-duct obstruction induced by chronic inflammation; and biliary sphincterotomy, which decreases resistance to bile flow leading to excretion of the tracer into the duodenum. The specificity of the test can be improved by intravenous administration of morphine, known as morphine cholescintigraphy, which induces spasm of this sphincter, thus increasing back pressure to fill the gallbladder. [18]


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