Gallbladderliver

Tc-99M DISIDA Tc-99m MEBROFENIN 5 mCi

NPO after midnight

Q5 min x 60 min, then Q1min/frame

All purpose collimator

Evaluation

1. Does the patient have a gallbladder?

2. Prompt hepatic uptake? Peak uptake? Distribution?

3. Appropriate blood pool washout?

4. Prompt excretion into intra and extra hepatic ducts?

POTENTIAL SCENARIOS

1. Bile Duct Obstruction

Normal state:

Uptake in liver 5-10 min

CBD 10 min

GB 60 min

Intestinal 60 min

Any delay beyond this is indicative of obstruction

2. Acute Cholecystitis

Augment study by giving: Morphine 0.04 mg/kg Sincalide 1-2 ^g slow i.v. 30 min Delay 4-6 h

3. Biliary Atresia

4. Biliary Leak

Cystic duct remnant

Choledochocele

Bowel

5. GB Ejection Fraction

Sincalide 0.02 ^g/kg a. Dyskenesia b. Normal = >30% at 30 min

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