Gastrointestinal GW Flashcards
Liver-spleen indications
Determination of size, configuration, and position
Detection of tumors, hematomas, cysts, abscesses, and trauma
Evaluation of function liver disease (cirrhosis and hepatitis)
RE cells are also called
Kupffer cells
RE cells are responsible for
Phagocytosis
Hepatocytes are responsible for
Bile formation
Liver/spleen RP
99mTc Sulfur Colloid
5-10 mCi
Liver/spleen acquisition
Flow
Statics taken after 10-15 mins
- all views
- ANT view w/marker on right costal margin for liver size and location, or left costal margin for spleen size
- breath holding views may be obtained for mobility of liver
SPECT optional
Imaging too soon on liver spleen scan will show
Cardiac blood pool activity
Imaging too soon on liver spleen scan will show
Cardiac blood pool activity
Liver/spleen scan upright acquisition considerations
Skin folds in obese patients
Breathing attenuation
Bile is a product of ______ and _____
Erythrocyte breakdown and Hepatocyte metabolism
Bile does what
Break down fats, stimulate peristalsis, enhance absorption of fatty acids
CCK is produced where
By the duodenum
What cells uptake RP for liver/spleen scan
RE (Kuppfer) cells
What cells uptake RP for HIDA
Hepatocytes
Cystic duct obstruction is also called
Acute cholecystitis
Patients with elevated bilirubin levels may need ________ dose of tracer
Higher
Morphine _____ the SOO
Constricts. Promotes back flow
Patient prep for HIDA
No pain killers or sedatives for 6-12 hours
fast 2-4 hours, but no more than 24 hours
GB is not visualized 1 hour after tracer
- what should you do?
Image out for up to 24 hours
Or
Give morphine
Protocol for CCK for patients who fasted more than 24 hours (or need hyperalimentation)
0.01-0.02 ug/kg over 3-5 minutes
Given 30-60 minutes before tracer
Can CCK be given after morphine
No, it would result in a falsely low EF
If gallbladder is visualized but small bowel is not
Image delays until it is
How long is imaging continued after morphine is given
30 minutes
What is biliary atresia
Blockage of ducts from the liver to the gallbladder
What is phenobarbital used for
To differentiate biliary atresia from other causes of neonatal jaundice
- tracer will not be excreted into the bowel in patients with biliary atresia
In patients with extremely high bilirubin levels may see
Kidneys on scan because they will take over excretion of tracer
Most common benign tumors of the liver
Cavernous hemangioma
Liver hemangioma RP
Tech labeled RBCs
20-25 mCi
Liver hemangioma acquisition
Flow (optional)
Blood pool (optional)
Delay 45-180 minutes - SPECT preferred
Meckels is usually located
Distal ileum
Meckels rule of 2s
Found in 2% of the population
Meckels pt prep
Fast for 2 hours
No diagnostic tests or laxatives 3-4 days prior
Camera positioning for Meckels
Between xyphoid and symphysis pubis
Imaging time for Meckels
Sequential statics every 30-60 seconds for 30-60 minutes
Why are tech labeled RBCs better for intermittent GI bleeding?
Because tracer stays in blood pool for longer which allows for delayed imaging
Gastro reflux RP
99mTc Sulfur colloid
- adults: mixed with 150 mL of OJ and 150 mL of hydrochloric acid
- babies: mixed with formula and given through nasogastric tube or baby bottle
Patient position for gastro reflux study
Supine with abdominal binder
- serial images obtained
Pt prep for gastric emptying
NPO 4 hours minimum
Prokinetic agents and agents that delay emptying stopped 2 days prior
Premenopausal women should ideally be studied on days 1-10 or cycle
Proximal part of stomach
Fundus
Distal part of stomach
Antrum
3 pairs of salivary glands
Parotids
Submandibular
Sublingual
Salivary gland imaging RP
99mTc pertechnetate
10 mCi
Salivary gland acquisition
Flow optional
ANT images every 5 minutes
LATs at 30 minutes
If obstruction is suspected, pt will suck on a lemon
- ANT and LATs taken 10 mins later
Leveen shunt is placed where
Draining fluid in peritoneal cavity through tube in the internal jugular being into the superior vena cava
Leveen shunt RP
99mTc Sulfur Colloid
99mTc MAA
1-2 uCi into the peritoneal space
Leveen shunt image acquisition
Serial imaging begins when lower part of tube is visualized
Liver/spleen or lung imaging is performed 1 hour after
Delays may be necessary
H pylori produces
Urease, which is not typically found in stomach
Breath test prep
Overnight fast
Swallows C14 urea pill and blows into balloon 10-15 mins later
Breath test RP
C14 urea oral pill
1 uCi
Given 10-15 minutes prior to breath sample
