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HIDA Scan

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HIDA Scan, Hepatobiliary Iminodiacetic Acid, Radionuclide Cholescintography, Hydroxy-Iminodiacetic Acid, Technetium Tc 99m Lidofenin, DISIDA Scan, Diisopropyl Iminodiacetic Acid, Technetium Tc 99m Disofenin, PIPIDA Scan, Paraisopropyl Iminodiacetic Acid, BrIDA Scan, Technetium Tc 99m Mebrofenin, Cholecystokinin-HIDA Scan, Radionuclide Biliary Patency Study, Radionuclide Hepatobiliary Study with CCK

  • See Also
  1. Gallbladder Ultrasound
  2. Magnetic Resonance Cholangiopancreatography (MRCP)
  • Indications
  1. Acute Cholecystitis
  2. Biliary Diskinesia
  3. Acalculous Cholecystitis
  • Mechanism
  • Visualization of biliary tree (liver and gallbladder function)
  1. Hepatobiliary Iminodiacetic Acid (IDA) is normally taken up by the liver and excreted into the bile
  2. When tagged with Technetium-99, IDA can be visualized with a gamma camera
  • Preparations
  • Technetium-99 Tracers
  1. HIDA Scan (Hydroxy-Iminodiacetic Acid)
    1. Replaced with other tracing agents (although scan still referred to as HIDA)
    2. Previously Serum Bilirubin determined the agent used (HIDA was used if Total Bilirubin <5-7 mg/dl)
  2. DISIDA Scan (Diisopropyl Iminodiacetic Acid)
  3. PIPIDA Scan (Paraisopropyl Iminodiacetic Acid)
  4. BrIDA Scan (bromo-2, 4,6-trimethylacetanilido Iminodiaceticacid)
  • Technique
  1. HIDA Scan (or DISIDA, PIPIDA or BrIDA Scan)
    1. Technetium-iminodiacetic acid analog injected IV (see preparations above)
    2. Technetium-iminodiacetic acid analog is absorbed and secreted into biliary tract by hepatocytes
  2. Cholecystokinin-HIDA Scan
    1. HIDA Scan is performed before and after Cholecystokinin (CCK) administration
    2. Cholecystokinin stimulates gallbladder contraction
    3. Assessment of gallbladder contractility and ejection fraction
    4. Symptoms reproduced with Cholecystokinin (CCK) injection are suggestive of Biliary Colic
  • Interpretation
  1. Normal Billiary tract and Gallbladder
    1. Clear outline gallbladder and cystic duct in 2 hours
  2. Cystic duct obstruction
    1. Failure to outline Gallbladder within 2 hours
  1. Test Sensitivity: 97%
  2. Test Specificity: 77%
  3. Negative Predictive Value: 99%
  • References
  1. Abraham (2014) Am Fam Physician 89(10): 795-802 [PubMed]