Hospitals & Services
99mTc-DISIDA evaluates hepatocellular function, gallbladder function and patency of the Biliary system by tracing the production and flow of bile from the liver, through the Biliary system into the small intestine.
Although ultrasound is the preferred imaging investigation for the diagnosis of acute cholecystitis, biliary scanning has high sensitivity and specificity for diagnosing this condition. If the gallbladder is not visualised this may indicate cystic duct obstruction and supports the diagnosis of acute cholecystitis. False negatives can occur in acalculus cholecystitis (1-2% of cases), and false positives can be seen with chronic cholecystitis, pancreatitis, and prolonged parenteral nutrition.
The response to IV morphine is used to diagnose sphincter dysfunction after cholycystectomy. Opiates increase sphincter tone and therefore precipitate attacks of biliary type pain in some people
In some cases IV morphine may need to be given to enhance gallbladder filling.
Biliary scans can also show gall bladder filling and emptying as a measure of gall bladder ejection fraction in patients with episodes of biliary type pain and non-diagnostic ultrasound examinations.
Diagnosis of acute cholecystitis.
Assessment of gall bladder function with CCK or Ensure.
Assessment of patients with post cholecystectomy pain syndrome and suspected Sphincter of Oddi Dysfunction SOD (requires IV morphine administration).
Distinguishing Biliary Atresia from hepatitis in neonates with jaundice.
Distinguishing Focal Nodular Hyperplasia from other hepatic lesions.
Demonstration of choledochal cysts.
Detection of post-operative bile leaks
Nil by mouth for at least 4 hours (2 hours for infants) and preferably overnight, but no longer than 24 hours -the patient should not be on parenteral nutrition
Opiate drugs must be discontinued for 6 - 12 hours.
Infants with suspected biliary atresia should be pre-treated with 5mg/kg of oral phenobarbitone for 3-5 days prior to the scan.
Sequential images of the liver and abdomen are obtained for 1 - 2.5 hours.
Patients with suspected S.O.D. may require a second scan without morphine at least 2 days after the scan with morphine. Each scan takes 90 minutes.
Patients with suspected gall bladder dysfunction are given a 30 minute IV infusion of CCK after the gall bladder has filled. Ensure Plus (a liquid food drink) may sometimes be given instead of the CCK. The whole procedure takes approx. 2.5 hours.
Neonates with suspected Biliary Atresia may require additional views up to 24 hours, depending on the initial findings.
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