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At the time the article was created Matt A. Morgan had no recorded disclosures.View Matt A. Morgan's current disclosures
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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 Tc-99m-IDA analogs, and "hepatic "IDA" imaging gave rise to the more common term "HIDA scan."
Cholescintigraphy can be used for the evaluation of ref:
- the most common use is to confirm acute cholecystitis after an equivocal ultrasound study
- if the tracer does not enter the gallbladder after a sufficient 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: good hepatic uptake of the tracer with no evidence of excretion into the bowel at 24 hours
- 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: may be useful in imaging choledochal cysts
- sphincter of Oddi dysfunction
With the exception of biliary atresia (and possibly chronic cholecystitis), cholescintigraphy is rarely a first-line imaging modality but is often used as a problem-solving tool.
Tracer dose and route of administration
After intravenous injection, IDA radiotracers are taken up by hepatocytes and then excreted into the biliary system ref.