Cholescintigraphy

Cholescintigraphy is the use of radiotracers to assess the anatomy and function of the biliary system (and the liver indirectly). Currently this is most commonly performed with Tc99m-IDA analogues, and "h"epatic "IDA" imaging gave rise to the more common term "HIDA scan."

After intravenous injection, IDA radiotracers are taken up by hepatocytes and then excreted into the biliary system. This then can be useful for evaluation of 

  • acute cholecystitis:
    • most common use is to confirm acute cholecystitis after an equivocal ultrasound study
    • if the tracer does not enter the gallbladder after a sufficent length of time, then this is compatible with obstruction of the cystic duct
  • chronic cholecystitis
    • diagnosed if an adequate % of bile mixed with radiotracer does not exit the gallbladder after administration of CCK
  • biliary atresia in neonates
  • bile leak
    • if tracer spreads outside the biliary system, it provides direct evidence of a biliary leak
  • biliary obstruction
    • tracer dose is held up before it can progress into the duodenum
  • confirmation of biliary dilatation

With the exception of biliary atresia (and possibly chronic cholecystitis), cholescintigraphy is rarely a first line imaging modality, but is often useful as a problem-solving tool.

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Article Information

rID: 46822
Synonyms or Alternate Spellings:
  • HIDA scan

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Cases and Figures

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    Case 1: Normal HIDA scan (acute cholecystitis)
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    Case 2: Normal HIDA scan (for gallbladder dysfunction)
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    Case 3: Chronic cholecystitis
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    Case 4: Gallbladder dysfunction
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