Utility of indium-111-labeled leukocyte imaging in acute acalculous cholecystitis

Abstract

The reported sensitivity of cholescintigraphy in acute acalculous cholecystitis varies from 45 to 1 00% with an average sensitivity (based on combining the results in the literature) of 75% [1 -i i 1. This figure is significantly lower than the sensitivity reported for acute calculous disease [2, 7, 9]. In addition, acalculous cholecystitis often occurs in patients with severe intercurrent illnesses and those on hyperalimentation, conditions that can cause nonvisualization of the gallbladder on cholescintigraphy in the absence of gallbladder disease [1]. We present two patients with acute acalculous cholecystitis who had indium-i 1 1 (In-i 1 1) labeled leukocyte uptake in the gallbladder in a doughnut pattern. It appears that the leukocyte scan can detect acalculous cholecystitis. The leukocyte scan may be helpful in diagnosing or excluding acute acalcubus cholecystitis in patients in whom the cholescintigram results (either positive or negative) are questioned.