II. Indications

III. Mechanism: Visualization of biliary tree (liver and gallbladder function)

  1. Hepatobiliary Iminodiacetic Acid (IDA) is normally taken up by the liver and excreted into the bile
  2. When tagged with Technetium-99, IDA can be visualized with a gamma camera

IV. Preparations: Technetium-99 Tracers

  1. HIDA Scan (Hydroxy-Iminodiacetic Acid)
    1. Replaced with other tracing agents (although scan still referred to as HIDA)
    2. Previously Serum Bilirubin determined the agent used (HIDA was used if Total Bilirubin <5-7 mg/dl)
  2. DISIDA Scan (Diisopropyl Iminodiacetic Acid)
  3. PIPIDA Scan (Paraisopropyl Iminodiacetic Acid)
  4. BrIDA Scan (bromo-2, 4,6-trimethylacetanilido Iminodiaceticacid)

V. Technique

  1. HIDA Scan (or DISIDA, PIPIDA or BrIDA Scan)
    1. Technetium-iminodiacetic acid analog injected IV (see preparations above)
    2. Technetium-iminodiacetic acid analog is absorbed and secreted into biliary tract by hepatocytes
  2. Cholecystokinin-HIDA Scan
    1. HIDA Scan is performed before and after Cholecystokinin (CCK) administration
    2. Cholecystokinin stimulates gallbladder contraction
    3. Assessment of gallbladder contractility and ejection fraction
    4. Symptoms reproduced with Cholecystokinin (CCK) injection are suggestive of Biliary Colic

VI. Interpretation

  1. Normal Billiary tract and Gallbladder
    1. Clear outline gallbladder and cystic duct in 2 hours
  2. Cystic duct obstruction
    1. Failure to outline Gallbladder within 2 hours

VII. Efficacy: Acute Cholecystitis

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