| Discussion: |
-Technitium 99m iminodiacetic acid analogs are used.
-Most widely used radiopharmaceutical is Tc99m diisopropyl IDA (DISIDA)
-Minimum of 2 hours fasting is suggested in acute disease
-Liver well seen at 5 minutes
-Gallbladder, common bile duct, and duodenum usually visualizied within first 30 minutes. Delayed images are needed if not seen by one hour.
-Morphine may be given to cause spasm of the sphincter of Oddi and filling of the gall bladder.
-Two-thirds of biliary flow bypasses the gallbladder and enters the duodenum.
-Amount of entry into the gallbladder depends on the nutritional state of the pateint, tone of the sphincter of Oddi, and any concurrently administered medications.
-Ejection fractions less than 30% are abnormal. EF of 30-50% are equivocal. Normal gall bladder ejection fraction is greater than 50%