Cholescintigraphy

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Cholescintigraphy
Normal hepatobiliary scan (HIDA scan). The nuclear medicine hepatobiliary scan is clinically useful in the detection of the gallbladder disease.
ICD-9-CM92.02
OPS-301 code3-707.6

Cholescintigraphy or hepatobiliary scintigraphy is scintigraphy of the hepatobiliary tract, including the gallbladder and bile ducts. The image produced by this type of medical imaging, called a cholescintigram, is also known by other names depending on which radiotracer is used, such as HIDA scan, PIPIDA scan, DISIDA scan, or BrIDA scan.[1][2] Cholescintigraphic scanning is a nuclear medicine procedure to evaluate the health and function of the gallbladder and biliary system. A radioactive tracer is injected through any accessible vein and then allowed to circulate to the liver, where it is excreted into the bile ducts and stored by the gallbladder[3] until released into the duodenum.

Use of cholescintigraphic scans as a

bile reflux cholescintigraphy may be the first choice.[5]

Medical use

In the absence of gallbladder disease, the gallbladder is visualized within 1 hour of the injection of the radioactive tracer.[citation needed]

If the gallbladder is not visualized within 4 hours after the injection, this indicates either cholecystitis or cystic duct obstruction, such as by cholelithiasis (gallstone formation).[6]

Cholecystitis

The investigation is usually conducted after an

right upper quadrant for a patient presenting with abdominal pain. If the noninvasive ultrasound examination fails to demonstrate gallstones, or other obstruction to the gallbladder or biliary tree, in an attempt to establish a cause of right upper quadrant pain, a cholescintigraphic scan can be performed as a more sensitive and specific test.[citation needed
]

Cholescintigraphy for acute

Kasai portoenterostomy or hepatoportoenterostomy can save the life of the baby as the chance of a successful operation after 3 months seriously decreases.[9]

Biliary dyskinesia

Cholescintigraphy is also used in diagnosis of the biliary dyskinesia.

Radiotracers

Most

radiopharmaceuticals include the following:[10][11]

Nonproprietary drug name (USP format) Common chemical name Acronym Comments
technetium Tc 99m lidofenin hepatobiliary iminodiacetic acid;[12] dimethyl-iminodiacetic acid[10] HIDA An early and widely used tracer; not used as much anymore, as others have progressively replaced it,[13][6] but the term "HIDA scan" is sometimes used even when another tracer was involved, being treated as a catch-all synonym.
technetium Tc 99m iprofenin paraisopropyl-iminodiacetic acid[10] PIPIDA
technetium Tc 99m disofenin diisopropyl-iminodiacetic acid[10] DISIDA
technetium Tc 99m mebrofenin trimethylbromo-iminodiaceticacid[12] BrIDA
  diethyl-iminodiacetic acid[10] EIDA Seems to have been a laboratory tracer but never widely used clinically
  parabutyl-iminodiacetic acid[10] PBIDA Seems to have been a laboratory tracer but never widely used clinically
    BIDA[14] Seems to have been a laboratory tracer but never widely used clinically
    DIDA[14] Seems to have been a laboratory tracer but never widely used clinically

Etymology and pronunciation

The word cholescintigraphy (

combining forms of chole- + scinti(llation) + -graphy
, most literally "bile + flash + recording".

References

  1. PMID 21861996
    .
  2. ISBN 9783319061115
    .
  3. ^ Michael, Picco, M.D. "HIDA scan (cholescintigraphy): Why is it performed?". Mayo Clinic. Retrieved 2007-12-11.{{cite web}}: CS1 maint: multiple names: authors list (link)
  4. ISBN 978-3-319-67066-9
    .
  5. S2CID 6118821
    .
  6. ^
    PMID 21078782
    .
  7. PMID 7979854
    .
  8. ISBN 978-1-4419-7776-2
    . Retrieved 23 August 2012.
  9. ISBN 978-0-323-05407-2
    . Retrieved 23 August 2012.
  10. ^
    S2CID 12260768
    .
  11. PMID 6897074
    .
  12. ^ a b Elsevier, Dorland's Illustrated Medical Dictionary, Elsevier.
  13. ISBN 978-3-642-00647-0
    .
  14. ^
    PMID 24744445
    .
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