Cholescintigraphy

WHAT IS A HIDA SCAN?

Cholescintigraphy (also known as HIDA scan) is a diagnostic test, used to capture images of the liver, gallbladder, bile ducts, and small intestine, to help determine the medical conditions of these organs.

HIDA scan stands for “Hepatobilary Iminodiacetic Acid” scan. The HIDA scan shows how well your gallbladder is working, as well as checks your liver function since both organs are working closely together.

The gallbladder is a small organ (beneath the liver), that stores bile, a fluid made in the liver, to break down fat and help with digestion. 

Cholescintigraphy is also known as “hepatobilary scan” or “hepatobiliary scintigraphy”. The scan involves injecting a radioactive tracer into your bloodstream which moves into your body parts to be captured. A special camera takes picture of the tracer’s movement and transmits energy unto a computer screen for view and diagnosis

BENEFITS OF HIDA SCAN

• HIDA (hepatobilary iminodiacetic acid) scan can measure the rate at which the gallbladder releases bile (also known as gallbladder ejection fraction).
• It can be used to look for gall stones
• To determine bile leakage or fistules
• To locate blocked bile ducts.
• To check the liver’s bile excretion function.
• To trace the path of bile from the liver to the small intestine
• To find the cause of the right abdominal pain.
• If you have had a liver transplant, a HIDA scan can help check if the new liver is working well.
• To look for congenital bile duct defects, like biliary atresia.
• It can identify cholecystitis (an inflamed gallbladder).
• To uncover the cause of jaundice. 

HIDA SCAN PREP

• Fast for 4 hours before your HIDA scan.
• You may drink clear liquids.
• Tell your doctor about all medications and supplements you take.
• You may be asked to avoid all medications after your test.
• Let your doctor know if you are pregnant or breastfeeding.
• You may have to keep all your jewelry and dentures at home, as you go for the test.
• It is better to go to the test with free-flowing clothing.
• Arrange to go with a friend or relation who would take you home after the test.

THE HIDA SCAN PROCEDURE

Duration: The HIDA test would run for 1─4 hours.

Venue: The cath laboratory.

Specialist: A specialized doctor (urologist). It is performed by an imaging technician.

• You will be instructed to lie with your back, on a table and stay still.
• The imaging technician will position a camera called a scanner above your belly.
• The technician put’s an IV needle into a vein in your arms or hand.
• He/she will inject a radioactive tracer into the IV, so it enters your vein
• The tracer will travel through your bloodstream to your liver, the bile-making cells absorb it then the tracer moves with the bile into your gallbladder through the bile duct, and into the small intestine.
• With a controlled camera, images of the tracer are taken, as it moves through your body.
• You’ll be injected with morphine (a type of pain medicine) through your IV line.
• The morphine will help to move the tracer into your gallbladder.

HIDA SCAN WITH CCK

Sometimes, the urologist may order a HIDA scan with cholecystokinin (CCK), a hormone that causes your gallbladder to empty and release bile. In this case, you will be given this medication by mouth or via one of your veins.  Images of your gallbladder will be taken before and after giving you CCK.

HIDA SCAN RESULTS

To conclude the diagnosis your doctor will consider your physical condition, abnormal symptoms, and your HIDA scan results. Your HIDA scan results may be as follows:

RESULTS	HIDA SCAN INDICATION
Normal	Free movement of the radioactive tracer with your bile from the liver into your gallbladder and small intestine.
Slow movement	Slower than normal movement of tracer through your body. This is likely to be a blockage or a liver problem.
Not present	If there is no sign of radioactive tracer in your gallbladder on the images, it may be a sign of acute gallbladder inflammation (acute cholecystitis).
Low gallbladder ejection fraction	If the amount of tracer leaving the gallbladder is not much after a dose of CCK to empty the gallbladder, you may have chronic inflammation of the gallbladder (chronic cholecystitis).
Radioactive tracer in the other parts of your body.	Images show signs of radioactive tracers outside your liver, gallbladder, bile duct, and small intestine. You may leak into the biliary system.

 

A normal result means that the gallbladder is viewed within 1 hour of the injection and the tracer is in the small intestine.

HIDA SCAN SIDE EFFECTS AND RISKS

HIDA scan, despite its safe estimation by doctors, has a little chance of side effects. Its potential risks include:

• Exposure to radiation.
• Allergic reaction to the tracer.
• Bruising at the site of chemical injection.

SYNONYMS OF HIDA SCAN

• Gallbladder scan.
• PIPIDA scan.
• The DISIDA scan.
• BriDA scan.
• Hiatal scan.
• Radionuclide cholescintigraphy.
• Cholecystokinin-HIDA scan.
• Nuclear medicine (NM) hepatobiliary scan.

Other related terms that need clarity may include:

• Gallbladder Scan

This is a specialized radiology procedure used to determine the function and structure of the gallbladder. It is sometimes referred to as a liver-biliary scan.

• Radiology Procedure

A radiology scan is an imaging procedure that is performed with radioactive material as a tracer. A HIDA scan radiology defines the procedure as using a radioactive tracer (in this case, hepatobiliary iminodiacetic acid).

HIDA SCAN COST 

The cost of a HIDA scan varies. If you are under the cover of insurance, you are at an advantage. Healthcare Bluebook states $1,200 as the average price for a single HIDA scan.

CONCLUSION

Most individuals can go normally about their daily activities after having a HIDA scan. Little amounts of the radioactive tracer that was injected into your blood will leave your body, via your urine and feces, within few days. It is recommended that you divide a lot of water to help remove the tracer out of your system, speedily.

FAQs

• How long does a HIDA scan last?

The HIDA procedure involves the injection of a small amount of a radioactive isotope and obtaining multiple-timed images over 1─4 hours. So expect not to stay beyond 4⅟₂ hours. 

• What happens if the HIDA scan is abnormal?

If your HIDA scan result is abnormal, your images likely revealed any of the following: gallstones, an infection, bile duct bondage, an abnormal growth, or a problem with how your gallbladder functions. Your doctor may want to repeat the HIDA scan or have you take another type of imaging test.

• Are HIDA scans always abnormal?

While HIDA scans demonstrate a greater sensitivity, specificity, and accuracy in diagnosing cholecystitis, compared to ultrasound, the sensitivity of its radioactive chemical may deteriorate with time.

• Should I eat a fatty meal before a HIDA scan?

Yes, eating a fatty meal before getting through a HIDA scan will make the gallbladder ready for the scan. Try drinking a glass of whole milk (since it has a fatty content). Don’t eat for four hours before the scan, but you can drink water and clear liquids.

• Does a HIDA scan with CCK hurt?

A HIDA scan with CCK can cause pain. Patients are to be aware that the test will likely bring on a very similar pain to what they felt previously. The test may be very painful, as the tracer flows through your bloodstream.