Hepatobiliary scintigraphy and sonography in early biliary obstruction.

The authors examined 139 patients thought to have early, partial, or intermittent biliary obstruction, using sonography, hepatobiliary scintigraphy, and in selected cases contrast cholangiography. Of 125 patients with a well-established final diagnosis, sonography and scintigraphy disagreed in 29 (23%). Scintigraphy revealed early or low-grade obstruction in 13 patients who had no evidence of dilated ductules, while 7 patients with dilatation from prior stone passage or biliary surgery showed normal clearance. The authors conclude that in a preselected population in whom early or low-grade biliary obstruction may be present, disagreement between sonography and scintigraphy is not rare, and the absence of sonographically detectable dilatation does not exclude obstruction.