TC-99M DISIDA HEPATOBILIARY SCINTIGRAPHY IN AIDS CHOLANGITIS

Sixteen patients with documented AIDS cholangitis who underwent Tc-99m DISIDA hepatobiliary scintigraphy were retrospectively reviewed to as sess the spectrum of changes observed in this disease. AIDS cholangiti s was documented by either ERCP with aspiration/biopsy or the presence of typical sonographic/CT abnormalities with positive stool culture a nd a minimum of 6 months follow-up. Images were graded as regards pare nchymal function (blood pool clearance, peak parenchymal activity, and degree of parenchymal retention), gallbladder visualization, presence of ductal dilatation, and time of intestinal activity. Three patterns were identified: 1)focal ductal dilatation with focal narrowing and f ocal or diffuse parenchymal retention; 2) ductal dilatation, without n arrowing, and diffuse parenchymal retention; and 3) severe diffuse par enchymal retention with or without ductal abnormality. All 16 studies revealed abnormal parenchymal retention. Gallbladder nonvisualization was demonstrated in nine studies and delayed in two. The hepatobiliary scan Is a very sensitive technique for evaluating AIDS cholangitis. A lthough a spectrum of findings may be observed, parenchymat retention with some degree of ductal abnormality is the most commonly observed p attern.