Image Based Question-71342

Identify the radiological procedure as shown in the image:

A. USG.

B. HIDA Scan.

C. Bone Scan.

D. DMSA Scan.

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Correct Answer » B Explanation

Ans:B. HIDA Scan.

HIDA Scan

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

• may be useful in imaging choledochal cysts

With the exception of biliary atresia (and possibly chronic cholecystitis), cholescintigraphy is rarely a first line imaging modality