HEPATOBILIARY HIDA

Question 1

Q1: What does a Hepato-biliary (HIDA) scan evaluate?

Answer 1

Q
A1: A HIDA scan evaluates the hepatocyte function of the liver, gallbladder, and biliary tracts/bile ducts.

Question 2

Q2: What function of the gallbladder can a HIDA scan assess?

Answer 2

A2: A HIDA scan is used to assess the contractile function of the gallbladder, specifically how well it excretes bile into the small bowel.

Question 3

Q1: What radiopharmaceutical is used in a Hepato-biliary (HIDA) scan?

Answer 3

A1: Tc-99m labelled DISIDA (di-isopropyl-imino-diacetic acid derivative).

Question 4

Q2: What are the benefits of using DISIDA in a HIDA scan?
A2:

Answer 4

Binds to albumin after IV administration.
Better absorption by the liver.
Faster excretion through bile ducts.
Provides better resolution for biliary tract imaging.

Question 5

Q3: Why is fasting required before a HIDA scan, and for how long?

Answer 5

A3: Fasting for 2-4 hours is required to avoid gallbladder contraction, which can decrease tracer concentration, leading to false-positive results. Fasting should not be too long.

Question 6

Q4: What drugs should be avoided before a HIDA scan?
A4: Drugs that suppress gallbladder function should be avoided.

Answer 6

A4: Drugs that suppress gallbladder function should be avoided.

Question 7

Q5: Describe the imaging procedure for a HIDA scan.

Answer 7

Inject DISIDA IV under a camera.
Acquire dynamic, static, and right lateral images.
Image until the gallbladder is seen.
Late imaging (4-6 hours or even after 24 hours) may be required for certain pathologies.

Question 8

Q6: What additional procedures may be performed during a HIDA scan?
A6:

Answer 8

Administering a fatty meal to improve gallbladder contraction.
Calculating gallbladder ejection fraction.
Administering drugs/hormones to accelerate gallbladder function.

Question 9

7: List some biliary pathologies that are indications for a HIDA scan.

Answer 9

Jaundice.
Biliary atresia in children.
Neonatal hepatitis.
Cholecystitis (acute/chronic).
Choledochus obstruction.
Cholangitis.
Gall reflux into the stomach.
Biliary trauma with gall leakage.
Post-operative evaluations.
Post-cholecystectomy syndrome.
Gastro-intestinal anastomoses.
Biliary/bowel bypass procedures.

Question 10

Q8: List some non-biliary pathologies that are indications for a HIDA scan.

Answer 10

Hepatomas.
Liver metastases.
Liver abscesses.
Pancreatic masses.
Intestinal obstruction.
Intestinal abscesses.
Functioning tumor lesions.