• The Korean Journal of Nuclear Medicine
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• v.25 no.1
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• pp.53-60
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• 1991

Extracorporeal shock wave lithotripsy (ESWL) with adjunctive oral litholytic therapy has proven to be a useful treatment in selected patients with gallbladder stones. To study the effect of ESWL on gallbladder dynamics, $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy was done for 25 patients with symptomatic gallstones and 10 normal controls. Of these 25 patients, 15 were treated with ESWL and adjunctive oral litholytic agents (ESWL group) and 10 were treated only with oral litholytic agents (UDCA group). After overnight fast and gallbladder visualization on a routine hepatobiliary scintigraphy with 7mCi of $^{99m}Tc-DISIDA$, subjects were given fatty meal and imaged with a gamma camera interfaced to a computer (1 frame/minute for 70 minutes). A gallbladder time-activity curve was generated and latent period (LP), ejection period (EP), ejection fraction (EF) and ejection rate (ER) were calculated. ESWL group were studied before, 1day after and 2weeks after ESWL, and WDCA group were studied before and 2weeks after starting oral medication. Mean basal EF was significantly reduced in patients but other parameters were not reduced. In ESWL group, mean EF and mean ER at lday after ESWL were reduced. In 3 of them, gallbladder was not visualized at all. Two weeks after ESWL, however, all parameters were recoverd to basal level. In UDCA group, all parameters were not changed significantly during medication. We can conclude that ESWL has such immediate adverse effect on gallbladder dynamics as reducing contractility and nonvisualization of gallbladder but it has no long-term effect.

• Journal of radiological science and technology
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• v.30 no.4
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• pp.391-397
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• 2007

Background/Aims : Gallbladder(GB) stone is the most common disease in the biliary system, and the incidence is gradually increasing in Korea. This change may include rapidly proceeding urbanization and changing food factor. We performed this study to investigate related GB stones and contraction of GB as dietary factors. Methods : We investigated 129 subjects(mean age : 47 years). GB stone group is 9 subjects(M: 2, F: 7) in Namyangju-si. Control group without GB stone is 18 subjects(M: 6, F: 12) in Wi-do island. For subjects without GB stone, diabetes mellitus decide 4(M: 2, F: 2) and then each after eat flesh and meat of estimated by experimental group ejection fraction rate(%). Results : Ejection fraction rate of GB were different between meat and fishes intake. When ate the meat in experiment for hypothetical verification, when become ejection fraction rate of meal GB 210 minutes, was the highest and when ate fish, the ejection fraction rate of GB was the highest in meal 120 minutes. Conclusions : After meats intaking the bile inside the GB is stagnant long and the GB stone is formed. We studied the results GB motility may important play a role on GB stone formation.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.2
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• pp.92-96
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• 2018

Purpose In case of nuclear medical hepatobiliary scan, To quantitatively evaluate contractility of a gallbladder, gallbladder ejection fraction (GBEF%) is calculated from anterior images using fatty meal. However, when a gallbladder and other organs overlap on an anterior image, the gallbladder ejection fraction is not accurately evaluated. In order to reduce this error, the objective of our study was to figure out whether there is a significant difference in GBEF% calculated from the anterior and right lateral images. Materials and Methods After intravenous injection of 99mTc-Mebrofenin 370 MBq to randomly 50 patients who visited our hospital, we started to examine nuclear hepatobiliary scan. Using skylight(Philips, United States), we acquired anterior and right lateral image at 10 minutes, 20 minutes, 30 minutes, 60 minutes, 90minutes after injection. Using images at 60 and 90 minutes, gallbladder ejection fraction (GBEF%) was calculated from the anterior and right lateral images using JETstream workspace. For drawing more accurate ROI, CT images were referenced and 4 radiologists calculated the GBEF% in the same image and calculated the average value. We assessed whether there was a significant difference in GBEF% calculated from the anterior and right lateral images using SPSS program(Statistical Package for the Social Science, SPSS Ver.18 Inc. USA). Results About randomly 50 patients, the average value of the GBEF% calculated from the anterior image was 63.212 and the average value of the GBEF% calculated from the right lateral image was 62.666. GBEF% decreased 0.433% on the right lateral image compared with anterior image. Result of paired sample t-test, p value is over 0.05. So, there was no significant difference in GBEF% calculated from the anterior and right lateral images. Conclusion In the case that a gallbladder and other organs are not separated on an anteior image, Right lateral image would be better to acquire more accurate GBEF% than using anterior image.

• Journal of radiological science and technology
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• v.32 no.2
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• pp.169-175
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• 2009

This study examined 40 healthy volunteers had been tested for their gallbladder (GB) volume and wall thickness by a real time ultrasonography before and after a meal. The results are as follows : 1. The mean values of GB volume were 47.40. (SD 9.05) for male, 35.72. (SD 8.30) for female. 2. The mean value of wall thickness of GB was 2.3 mm (SD 0.3, male, SD 0.5, female). 3. The mean ejection-fraction rates of GB result in 67.20% for male, 63.95% for female. 4. The values of GB volume had significant negative correlations (v = -.487, p < .000, male, v = -.509, p < .000, female) within 4 hours after a meal and significant positive correlations (v = .434, p < .000, male, v = .440, p < .000, female) afterward. 5. The wall thicknesses of GB were significant positive correlations (t = .310, p < .002, male, t = .116, p < .246, female) within 3 hours after a meal and significant negative correlations (t = -.288, p < .010, male, t = -.126, p < 7.10, female) afterward. 6. The relationship between volume and wall thickness of GB showed significant negative correlation.

• The Korean Journal of Nuclear Medicine
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• v.34 no.1
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• pp.55-61
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• 2000

Purpose: We performed this study to evaluate the changes of gallbladder ejection fraction (GBEF) in diabetic patients with or without autonomic neuropathy. Materials and Methods: This study included 37 diabetic patients (25 women, 12 men, mean age 51 years) and 24 normal controls (10 women, 14 men, mean age 38 years). After intravenous injection of 185 MBq of $^{99m}Tc$-DISIDA, serial anterior abdominal images were acquired before and after fatty meal. Regions of interest were applied on gallbladder and right hepatic lobe on 60 and 90 minute images to calculate GBEF. Results: GBEF was significantly reduced in diabetes with autonomic neuropathy ($43{\pm}12.3%$) and without autonomic neuropathy ($57.5{\pm}13.2%$) compared with normal controls ($68{\pm}11.6%$, p<0.05). And also, GBEF was significantly reduced in diabetes with autonomic neuropathy compared with diabetes without autonomic neuropathy (p<0.05). Fasting blood glucose level, age, sex, hemoglobin Alc, body mass index, serum lipid level were not different in these two diabetic patient groups (p>0.05). When 50.2% of GBEF was used as the criteria for diabetic autonomic neuropathy, the sensitivity and specificity were 80%, 76.5%, respectively. The area under receiver operating characteristic curve was 0.846. Conclusion: GBEF of diabetic patients with autonomic neuropathy was significantly reduced than that of diabetic patients without autonomic neuropathy.

• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.86-94
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• 1992

Quantitative analysis of gallbladder emptying is important in diagnosis of motility disorder of gallbladder and in studies of biliary physiology. However, the normal range of gallbladder ejection fraction (GBEF) has not been determined yet and the best method for stimulating the gallbladder to contract has not been elucidated adequately. The purpose of this study was to compare the gallbladder emptying effect of the fatty meal ingestion with that of the continuous infusion of cholecystokinin (CCK) and to establish the normal GBSF values of normal subjects. Quantitative hepatobiliary scan with $^{99m}Tc-DISIDA$ after a fatty meal was performed for 22 normal healthy volunteers. Among them, 10 subjects repeated the test with a fatty meal. Again, for 7 subjects quantitative heaptobiliary scan with an infusion of CCK (sincalide) at a rate of 20 ng/kg/hr for 45 minutes was performed repeatedly. The results were as follows. 1) With a fatty meal, the mean GBEF was $89.6{\pm}8.2%$ in 22 normal subjects, and there was no difference between subjects. 2) With a continuous infusion of CCK, the mean GBEF was $62.4{\pm}16.6%$ in 7 normal subjects, and there was a significant difference between subjects(p<0.05). 3) The reproducibility of GBEF by a fatty meal was significantly higher than by an infusion of CCK (p < 0.05). 4) The mean GBEF by a fatty meal was significantly higher than that by an infusion of CCK (p < 0.05). We concluded that a fatty meal is superior to a continuous infusion of CCK for inducing gall-bladder contraction because that induces more complete emptying and the response is more reproducible and constant.