Comparison of intravenous radionuclide cholescintigraphy and endoscopic retrograde cholangiography in the diagnosis of intrahepatic gall-stones.

Intravenous radionuclide cholescintigraphy using 99Tcm-pyridoxylideneglutamate (Tc-99m-PG) has been compared with endoscopic retrograde cholangiography (ERC) as a test for the pre-operative detection in intrahepatic gall-stones. Sixty-three patients, 42 of whom were clinical jaundiced, were studied and 27 of these were subsequently shown to have intrahepatic gall-stones. Cholescintigraphy correctly predicted stones in all but five of these patients (false negative 19%), while ERC failed to show intrahepatic stones in seven patients (false negative 26%). In the 36 patients found to have intrahepatic stones, cholescintigraphy was incorrect in six patients (false positive 17%) and ERC incorrect in two (false positive 6%). Cholescintigraphy is at least as successful as ERC in predicting intrahepatic gall-stones and is cheaper and less invasive. In population where intrahepatic gall-stones are common, it is likely to prove valuable as a pre-operative screening test.