Unformatted text preview: â€«)â€ªHepatobiliary Scan (HIDAâ€¬â€¬
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â€¢ Tc99mÂHIDA shares the same hepatocyte uptake, transport, and excretion pathways as bilirubin.
â€¢ HIDA is excreted in its original radiochemical form without being conjugated or undergoing significant metabolism. Biliary System Technique
â€¢ Filling dynamic images are obtained for 60 minutes (1 image per minute).
â€¢ Emptying dynamic images are obtained for 30Â
60 minutes post fatty meal.
â€¢ CCK can be injected instead of fatty meal if available. Filling Phase Emptying phase Normal HIDA Scan
ducts GB Small
bowel Gallbladder Ejection
â€¢ It is a numerical estimation of the function of the gallbladder.
â€¢ Normally it should be greater than 50%.
â€¢ It is calculated as: End filling volume Â End emptying volume x 100% End filling volume Normal Parameters
â€¢ Gallbladder must be visualized within the filling phase.
â€¢ Bowel must be visualized during the test.
â€¢ Gallbladder EF should be normal Indications for HIDA Scan
â€¢ Chronic cholecystitis.
â€¢ Evaluation of biliary atresia in neonates.
â€¢ Detection of post cholecystectomy biliary leak. Biliary Dyskinesia
â€¢ It is also called chronic acalculus cholecystitis.
â€¢ The patients suffer from chronic abdominal pain which is mostly biliaryÂlike pain.
â€¢ The pain is not attributable to any known organic abdominal disease.
â€¢ Routine work up is usually unremarkable (blood chemistry, ultrasound, CT scan, upper/lower endoscopy, â€¦ etc) Biliary Dyskinesia
â€¢ No gallbladder stone disease by ultrasound.
â€¢ Evaluation of gallbladder contraction has proven most useful in the diagnosis of this entity.
â€¢ Gallbladder ejection fraction is usually reduced (< 50%). Biliary Atresia
â€¢ HIDA scan is an accurate and nonÂinvasive test in the diagnosis of biliary atresia and in differentiating it from other causes of neonatal jaundice.
â€¢ NonÂvisualization of the bowel suggests biliary atresia (surgical jaundice). Hepatisis and hepatocellular dysfunction could be other causes of this finding. Biliary Atresia
â€¢ Negative scan (bowel visualization = biliaryÂ
toÂbowelÂtransit) excludes biliary atresia.
â€¢ Positive scan (nonÂvisualization of the bowel) suggests the diagnosis of biliary atresia. Hence, liver biopsy is needed. Biliary Atresia Biliary Leak
â€¢ Postoperative biliary leak can be evaluated with HIDA scan.
â€¢ 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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- Fall '08
- biliary atresia, Biliary Dyskinesia, biliaryÂ leak