MyPACS.net: Radiology Teaching Files > Case 818324

never visited NORMAL HIDA SCAN
Contributed by: Children's Hospital Omaha, Radiologist, Omaha Childrens, Creighton University and UNMC, Nebraska, USA.
History: Right upper quadrant pain.
Images:[small]larger

Fig. 1: HIDA scan showing filling of gall bladder on the 5-10 minute image and bowel activity at 15-20 minutes. Note normal anterior position of gall bladder on lateral view.

Fig. 2: Gall bladder ejection fraction within normal limits
Diagnosis: Normal HIDA scan.
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%

References:

Mettler, Fred. Essentials of Nuclear Medicine Imaging. W.B. Saunders Company, 1998.

Submitted by:
Chad Eicher, M.D. Radiology Resident, Creighton University Medical Center.

Comments:
No comments posted.
Additional Details:

Case Number: 818324Last Updated: 11-20-2004
Anatomy: Gastrointestinal (GI)   Pathology: Normal/Variants
Modality: Nuc MedExam Date: Access Level: Readable by all users

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