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HIDA scanning in gall-bladder disease

R W Nicholson, D L Hastings, H J Testa

    The British Journal of Radiology
    |September 1, 1980
    PubMed
    Summary
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    Technetium-99m labeled iminodiacetic acid (HIDA) scans effectively visualize the gallbladder. An absent gallbladder image in acute abdomen cases strongly suggests acute gallbladder disease, making HIDA scans a valuable diagnostic tool.

    Area of Science:

    • Hepatobiliary imaging
    • Nuclear medicine
    • Radiopharmaceutical diagnostics

    Background:

    • Technetium-99m labeled iminodiacetic acid (HIDA) is a radiopharmaceutical for hepatobiliary imaging.
    • It is selectively taken up by the liver and excreted into the biliary tree.
    • HIDA has demonstrated gallbladder visualization in normal subjects.

    Purpose of the Study:

    • To evaluate the diagnostic utility of 99Tcm-HIDA scans in various hepatobiliary conditions.
    • To determine the effectiveness of HIDA scans in visualizing the gallbladder across different patient groups.
    • To assess the role of HIDA scans in diagnosing acute gallbladder disease within the context of an acute abdomen.

    Main Methods:

    • Dynamic liver scans using 99Tcm-HIDA were performed on 97 patients.

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  • Patients were categorized into six groups: normal, hepatocellular disease, biliary obstruction, chronic gallbladder disease, acute gallbladder disease, and acute abdomen.
  • Gamma-camera computer systems generated activity-time curves and gallbladder images.

    • Main Results:

    • Gallbladder visualization occurred in all normal subjects and patients with acute abdomen not due to gallbladder disease.
    • No gallbladder visualization was observed in patients with acute gallbladder disease.
    • Gallbladder visualization was absent in 42% of hepatocellular disease patients and none with biliary obstruction.
    • In chronic gallbladder disease, HIDA visualization correlated with oral cholecystogram findings.

    Conclusions:

    • An absent gallbladder image on 99Tcm-HIDA scan, coupled with a normal hepatogram, strongly supports acute gallbladder disease diagnosis.
    • Gallbladder visualization effectively excludes acute gallbladder disease.
    • 99Tcm-HIDA scans are a useful first-line investigation for patients presenting with acute abdomen.