NucMed Boards Prep
IMAGE INTERPRETATION · HEPATOBILIARY AND GI

Patient Preparation for a HIDA Scan

Tc-99m mebrofenin hepatobiliary scan: 12 sequential frames over the first hour
Tc-99m mebrofenin hepatobiliary scan: 12 sequential frames over the first hour

Provided clinical image

Question

Before performing this type of hepatobiliary scan, what patient preparation is required to ensure a diagnostic study?

  1. AThe patient should eat a full meal 30 minutes prior to the study to stimulate bile flow and maximize gallbladder contraction before tracer injection
  2. BNo preparation is required; the patient may eat and drink normally up to and including the time of the radiopharmaceutical injection
  3. CThe patient should fast for 2–4 hours before the study, as recent food intake causes gallbladder contraction and may prevent normal gallbladder filling during imaging
  4. DThe patient must fast for a minimum of 24 hours and receive a laxative the evening before to ensure complete bowel clearance prior to injection
Show the answer and explanation

C. The patient should fast for 2–4 hours before the study, as recent food intake causes gallbladder contraction and may prevent normal gallbladder filling during imaging

Patients should fast for 2–4 hours before a Tc-99m mebrofenin hepatobiliary scan. Eating causes cholecystokinin (CCK) release, which contracts the gallbladder and prevents it from filling with tracer during the study, leading to false non-visualization. However, prolonged fasting (>24 hours) can also cause non-visualization of the gallbladder due to inspissated bile, so the 2–4 hour window is important. Morphine sulfate or sincalide (CCK) may be used to improve diagnostic accuracy in some protocols.

More hepatobiliary and gi images

Dynamic abdominal scan: sequential frames at 3 min/frame from 30 to 60 minutes post-injectionMeckel’s Diverticulum Scan with Tc-99m Pertechnetate Tc-99m HIDA scan post-morphine augmentation (2-minute frames, 0–70 min) — absent gallbladder filling despite biliary excretion, consistent with acute cholecystitisAcute Cholecystitis on HIDA Scan with Morphine Tc-99m HIDA with CCK infusion (LAO15, 4 min/frame) — gallbladder fills but GBEF = 22% at 59 min, consistent with biliary dyskinesiaLow Gallbladder Ejection Fraction on CCK HIDA Tc-99m HIDA scan (5–50 min and 4 hr) showing hepatic uptake with absent biliary excretion into bowel — pattern of biliary atresiaBiliary Atresia on Neonatal HIDA Scan Tc-99m RBC scan (ANT 60 min, sequential frames) — focal activity appearing in the right lower quadrant and migrating along the colon, indicating active GI hemorrhageActive Lower GI Bleed on Tagged RBC Scan Tc-99m mebrofenin hepatobiliary scan: 12 sequential frames over the first hourNormal Hepatobiliary Scan Sequence (Mebrofenin)
← Normal Hepatobiliary Scan Sequence (Mebrofenin)Meckel’s Diverticulum Scan with Tc-99m Pertechnetate →

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