Nuclear medicine hepatobilary imaging (
HIDA) is a time proven imaging methodology that uses radioactive drugs and specialized cameras to make imaging diagnoses based on physiology.
HIDA radiopharmaceuticals are extracted by hepatocytes in the liver and cleared through the biliary system similar to
bilirubin. The most common indication for
HIDA imaging is
acute cholecystitis, diagnosed by nonfilling of the gallbladder due to cystic duct obstruction.
HIDA can detect high grade biliary obstruction prior to ductal dilatation; images reveal a persistent hepatogram without biliary clearance due to the high backpressure.
HIDA also
aids in the diagnosis of partial biliary obstruction due to stones, biliary
stricture, and sphincter of Oddi obstruction. It can confirm biliary leakage postcholecystectomy and
hepatic transplantation. Calculation of a gallbladder ejection fraction after
cholecystokinin infusion is commonly used to diagnose chronic acalculous
gallbladder disease. Diseased gallbladders do not contract. There are many other less common but valuable diagnostic indications for
HIDA imaging.