Hepatobiliary/HIDA - Gallbladder

Overview

The Hepatobiliary Nuclear Medicine Study successively demonstrates hepatic perfusion, hepatocyte clearance, hepatic parenchymal transit and biliary excretion as the radiopharmaceutical moves from the injection site to the intestine.

Indications

  • Diagnosis of acute cholecystitis
  • Evaluation of extrahepatic biliary tract obstruction
  • Evaluation of the post-surgical biliary tract
  • Detection of bile leaks(No CCK used if gallbladder removed)
  • Diagnosis of biliary atresia and other congenitial anomalies of the biliary tract
  • Evaluation of liver transplants

Study Description

The patient receives a radiopharmaceutical intravenously. Serial images will be acquired at 5-15 minute intervals for approximately 1 hour. In some cases of a non-visualizing gallbladder, morphine may be administered to facilitate the contraction of the sphincter of Odi of the cystic bile duct allowing the gallbladder to fill and visualize. If the facility protocol, does not call for a morphine injection, then the images will still continue every 5-15 minutes for an additional 30 minutes. When the hepatobiliary scan approaches 60 minutes post injection and displays the appropriate normal pattern of the gallbladder “filling”, then kinevac (if applicable) will be given (0.02 ug/kg). During the injection of kinevac a 30 minute dynamic picture will be taken.

NOTE: If the kinevac injection is not requested for the procedure and the ordering doctor indicates “Hida without CCK” images will only be taken for the first 60 minutes (up to 90 minutes for gallbladder non-visualization) after the radiopharmaceutical is injected.

Examination Time

  • With CCK (Kinevac): 1 ½ hours (delayed images may be needed)
  • Without CCK (Kinevac): 1 hour

Patient Preparation

  • Ensure the patient is not pregnant or breastfeeding.
  • NPO (nothing by mouth) for a minimum of 4 hours to a maximum of 12 hours prior to exam
  • Patient off of narcotic drugs for 24 hours prior to exam
  • No BARIUM studies for 48 hours prior to exam
  • No CT CONTRAST (ORAL) for 4 hours prior to exam