Diagnostic values of gallbladder hyperperfusion and the rim sign in radionuclide angiography and hepatobiliary imaging.

The diagnostic values of hyperperfusion to the gallbladder fossa and the rim sign were retrospectively evaluated in 24 histopathologically proven cases of gallbladder disease. Although 12 of 13 patients (92%) with acute cholecystitis had nonvisualization of the gallbladder, the positive predictive value with this finding was 71%. However, when the finding was associated with hyperperfusion to the gallbladder fossa or the rim sign, the positive predictive value with both (90%) was markedly increased, compared to the prevalence ratio of 54%. Such a combination could be useful for preserving a high positive predictive value in the diagnosis of acute cholecystitis.