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Unformatted text preview: )Hepatobiliary Scan (HIDA
الدكتور قصي المقبل
أستاذ مشارك قسم الشعة والطب النووي
كلية الطبجامعة العلوم والتكنولوجيا الردنية Radiopharmaceutical
• Tc99mHIDA shares the same hepatocyte uptake, transport, and excretion pathways as bilirubin.
• HIDA is excreted in its original radiochemical form without being conjugated or undergoing significant metabolism. Biliary System Technique
• Filling dynamic images are obtained for 60 minutes (1 image per minute).
• Emptying dynamic images are obtained for 30
60 minutes post fatty meal.
• CCK can be injected instead of fatty meal if available. Filling Phase Emptying phase Normal HIDA Scan
ducts GB Small
bowel Gallbladder Ejection
• It is a numerical estimation of the function of the gallbladder.
• Normally it should be greater than 50%.
• It is calculated as: End filling volume End emptying volume x 100% End filling volume Normal Parameters
• Gallbladder must be visualized within the filling phase.
• Bowel must be visualized during the test.
• Gallbladder EF should be normal Indications for HIDA Scan
• Chronic cholecystitis.
• Evaluation of biliary atresia in neonates.
• Detection of post cholecystectomy biliary leak. Biliary Dyskinesia
• It is also called chronic acalculus cholecystitis.
• The patients suffer from chronic abdominal pain which is mostly biliarylike pain.
• The pain is not attributable to any known organic abdominal disease.
• Routine work up is usually unremarkable (blood chemistry, ultrasound, CT scan, upper/lower endoscopy, … etc) Biliary Dyskinesia
• No gallbladder stone disease by ultrasound.
• Evaluation of gallbladder contraction has proven most useful in the diagnosis of this entity.
• Gallbladder ejection fraction is usually reduced (< 50%). Biliary Atresia
• HIDA scan is an accurate and noninvasive test in the diagnosis of biliary atresia and in differentiating it from other causes of neonatal jaundice.
• Nonvisualization of the bowel suggests biliary atresia (surgical jaundice). Hepatisis and hepatocellular dysfunction could be other causes of this finding. Biliary Atresia
• Negative scan (bowel visualization = biliary
toboweltransit) excludes biliary atresia.
• Positive scan (nonvisualization of the bowel) suggests the diagnosis of biliary atresia. Hence, liver biopsy is needed. Biliary Atresia Biliary Leak
• Postoperative biliary leak can be evaluated with HIDA scan.
• Findings include visualization of free bile in the abdomen. Biliary Leak a b Abnormal accumulation of tracer extending superiorly and laterally
(a) and extending medially along the anteroinferior margin of the left
hepatic lobe (b). These findings are consistent with a biliary leak. ...
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This note was uploaded on 01/21/2012 for the course PDBIO 305 taught by Professor Woods,a during the Fall '08 term at BYU.
- Fall '08