Rim sign in Tc-99m sulfur colloid hepatic scintigraphy

Usha A. Joseph*, Bruce J. Barron, Lamk M. Lamki

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


A case of pericholecystic hyperperfusion on Tc-99m sulfur colloid (SC) flow images with a pericholecystic rim of increased activity (PCHA) on delayed planar and single-photon emission computed tomography images of the liver was seen in a patient with a history of multiple renal transplants admitted with cramping right lower quadrant abdominal pain. Laparotomy performed 5 days after the scan revealed an acutely perforated gangrenous gallbladder and occluded cystic duct. The secondary findings of gallbladder hyperperfusion and PCHA or "rim sign" have been frequently reported with Tc-99m IDA hepatobiliary imaging. These secondary findings in conjunction with a nonvisualized gallbladder on an IDA scan suggest a complicated or advanced stage of acute cholecystitis and usually require urgent surgical intervention. The rim sign on Tc-99m SC scintigraphy also likely indicates the same grave diagnosis.

Original languageEnglish
Pages (from-to)284-285
Number of pages2
JournalClinical Nuclear Medicine
Issue number4
Publication statusPublished - Apr 2005


  • Acute cholescystitis
  • Hepatic
  • Rim sign
  • Sulfur colloid

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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