Correlation of gallbladder ejection fraction with pathologic grade for chronic inflammation

Background. The purpose of this study is to define the sensitivity and spec ificity of the gallbladder ejection fraction (GBEF) for identifying patient s with various grades of histologically proven chronic cholecystitis. Methods. Of 693 consecutive patients who had a scintigraphic GBEF determina tion at Baptist Medical Center of Oklahoma, 161 subsequently had a cholecys tectomy at the same institution. Pathologic material was reassessed by one outside blinded reviewer, who graded the intensity of the inflammation pres ent on a 0 (absent) to 3 (most severe) scale. Results. The least square mean maximum GBEF was 23.7% for those with grade 0, 9.6% for those with grade 3, and 13.9% for those with cholesterolosis. I f a normal value for GBEF is set at >30%, the sensitivity for detecting gra de 1, 2, or 3 disease was 84%, and the specificity was 26%. For grade 3 dis ease alone, the sensitivity was 100%, and the specificity was 26%. Conclusions. The GBEF is sensitive but not specific for chronic inflammatio n of the gallbladder. The GBEF appears to be useful as a screening examinat ion in the appropriate clinical setting.