HIDA

Question 1

Dose

Answer 1

5 mCi Tc99m Choletec

1 mCi min peds dose

Question 2

Patient prep

Answer 2

NPO at least 4 hours but no more than 24 hours. If > 24 hours pre-treat with CCK.
DC IV lipids 4-6 hours.
DC morphine/ narcotics 4-6 hours.

Question 3

CCK

Answer 3

0.02 ug/kg infused over 20 min with automatic pump.

Same dose/ procedure for pre-treat and GBEF.

Question 4

R/O acute cholecystitis or obstruction

Answer 4

Inject on camera.
1 sec/frame for 1 min; 60 sec/frame for 60 frames.
IF bowel, no GB and decreased liver activity at 20-30 min give morphine. Image 30 min longer.
IF GB and no bowel, give CCK for GBEF.

Question 5

Evaluate for Liver function

Answer 5

NPO not necessary.

Image 60 min, QC.

Question 6

Evaluate for Biliary leak

Answer 6

NPO not necessary.
Image 60 min, QC.
Delays likely

Question 7

Biliary atresia

Answer 7

Confirm phenobarbital pre-treatment.
5 mg/kg for 5 days. Image 6th.
Image 90 min, then delayed at 4, 24 hours. After 90 min, take POS view

Question 8

Evaluation for GBEF.

Answer 8

When GB is "full" confirm with Dr. 
Prepare CCK with 5 mL sterile water.
Image 60 sec/frame for 30 frames. 
Complete kinevac flow sheet. 
Baseline + every 5 min BP. 
Infuse over 20 min