nuc med

gallbladder is against

inferior surface of liver

gallbladder fossa

in liver

hepatocytes form and

secrete bile

gallbladder working

bile secreted by liver is stored

cck is extracted from mucosa

cck passes thru bloodstream to GB, causing contraction9m9

99m IDA analogs

extracted from blood by the hepatocytes and are concentrated in bile

increased bilirubin levels effect the livers uptake and

secretion of the IDANCREASED I

increased bilirubin levels also increase

renal extraction of IDA

normal bilirubin levels

0.1 - 1.2 mg/dlormal n

kidney visualization on a HIDA scan is

abnormal

99mTc mebrofenin and disofenin

dose - depends on billirubin levels

adult - 3-10mci

kid - .05/kg, minimun = 1mci

active transport

indications

nausea

vomiting

biliary leaks after surgery

cholelithiasis

gall stones

cholecystectomy

gallbladder removal

patient prep for HIDA scan

2-6 hr fast

no opioids

if fasting over 24hr, pretreat w cck

dose - .02 micrograms/kg

HIDA procedure

supine

anterior camera

2-4 seconds per image, 30 frames

liver will show dimly then brightly

dynamic

1min frame for 60min

static

immediate

every 5min for 60 mins

set counts 500-1000k

morphine

dose - .04mg/kg or 2mg dose

given IV

continue imaging for 30-60 mins

cck

.02mcg/kg

given over 60 mins

longer infusion decreases the side effects

lessens chance of gallbladder spasms

interpretation

normal

can see liver

intra/extra ducts

gallbladder

small int

all appear in an hour

acute cholecystitis

cant see gallbladder

non visual in 1hr

tracer hangup in ductal sys

post morphine

shows chronic cholecystitis

constricts sphincter of dieim r

rim sign

rim of increased activity adjacent to empty gallbladder fossa

acute cholecystitis

common bile duct obstruction

bilirubin increased from a 0.9 to 2.1

prompt uptake of radiopharm by the liver is evidence of

good liver functional

lack of excretion into the biliary system suggest a

common bile duct obstruction

bile leak

scan shows good uptake in liver

no bowel excretion

POST INJ

bile leak in paracolic gutter

drained via abdominal drain

EF %

net max - net min / net max x100

gallstones cant be seen on

HIDA but can be seen on ultrasound

duct leading to small int

cystic

duct leading to small int

common

normal gallbladder EF

<35

CONTRA INDICATION

PATIENT PREP

What is the term for the formation of stones in the biliary tree?

gallstones

What does the term “patent” mean?

open or unobstructed

Convert 17 mCi to Ci

0.017

Convert 22 uCi to mCi

0.022

Convert 2 mCi to MBq

74