HIDA scan

• Indications
  • The HIDA scan should be done when ultrasound is not diagnostic and when there is a clinical diagnosis of acute cholecystitis.
• Mechanisms
  • Intravenous technetium labeled hepatic iminodiacetic acid (HIDA) is taken up by the hepatocytes and excreted into the bile.
  • After 30-60 minutes, the scan will show the flow of bile through the biliary tree including common bile duct, cystic duct, and gallbladder.
• Limitations
  • HIDA scans can be falsely positive when the gallbladder is not filling in the absence of cholecystitis. These situations include severe liver disease, patients on total parenteral nutrition, hyperbilirubinemia, inadequate fasting, and alcohol and opiate abuse.
  • In the presence of cystic duct obstruction the gall bladder does not fill with isotope.
• Normal HIDA Scan
• Abnormal HIDA Scan

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