Diagnosis of Hepatobiliary Disease by99mTc-HIDA Cholescintigraphy

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Abstract
99mTc-HIDA is concentrated by the hepatocytes and excreted into the biliary system; the gallbladder, common bile duct and early accumulation in the duodenum are visualized within 30 min of i.v. administration. The utility of 99mTc-HIDA imaging in both acute and chronic cholecystitis and hepatobiliary disease were studied in the presence of jaundice. All normal gallbladders exhibited filling, absence of visualization indicated gallbladder disease and/or cystic duct obstruction, visualization of the gallbladder after cholecystokinin-induced emptying excluded an obstructed cystic duct and acute cholecystitis, and a definitive diagnosis of hepatocellular disease. Partial and complete obstruction is possible in jaundiced patients with hyperbilirubinemias up to 5 mg%. Beyond that level, 99mTc-HIDA imaging was of qualified value. The technique is useful in assessing biliary drainage in jaundiced patients with surgically altered biliary tract anatomy.