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System Nuclear
Medicine
Par t 3
Hepatobiliary Imaging
Physiology
道 道
系 系
统 统
Principle
The hepatic parenchymal (polygonal)
cells constitute 85% of the hepatic
mass. Their function can be studied by
radiotracers such as Tc-99m labelled
iminodiacetic acid (IDA) or its
derivatives which are selectively
extracted by the liver polygonal cells
and excreted into the bile.
◆ Biliary imaging has become the procedure
of choice in evaluating patients with
suspected acute cholecystitis because in
virtually all cases of acute cholecystitis
there is obstruction of the cystic duct with
no passage of radionuclide into the
gallbladder.
◆ The test can also be used to detect
enterogastric reflux of bile and neonatal
biliary atresia as well as to assess biliary
kinetics (gallbladder ejection fraction) in
suspected chronic cholecystitis.
Indications:
◆ 1. Diagnosis of acute cholecystitis and
differentiate between acute cholecytitis
and pancreatitis
◆ 2. Diagnosis of biliary atresia,
◆ 3.Demonstration of patency of cystic and
common bile duct whenever oral or
intravenous cholecystograms are not
applicable.
◆ 4. Demonstration of improvement of
bile flow after relieve of obstruction,
◆ 5. Demonstration of complete obstructive
jaundice.
◆ 6.Work-up of patients with biliary
dyskinesis.
◆ 7. Study of bile reflux, postoperative
gastroduodenal reflux.
Radiopharmaceuticals