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What does my HIDA report result indicate?

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Posted on Fri, 27 Jan 2017
Question: I need assistance interpreting HIDA report. I had a CT the same day that was abnormal aside from this so doctors have not really addressed HIDA scan because CT results were a more urgent priority.
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Answered by Dr. Ramesh Kumar (57 minutes later)
Brief Answer:
Detail interpretation below.

Detailed Answer:
Hi,
Thanks for choosing health care magic for your query!

Before interpreting the reports first get a brief idea about what a HIDA scan is-
A HIDA scan, creates pictures of your liver, gallbladder, biliary tract and small intestine.HIDA scan is a type of imaging study in which a radioactive tracer is injected into a vein in your arm.This radioactive XXXXXXX is handled by the liver like bile hence by tracking it path we can access whether organ like gall bladder and the ducts connecting it are properly functioning or not.

Overall An abnormal gallbladder ejection fraction is considered less than 35% and is not affected by age.However in your case its just 16% at the end of 60minutes.A gallbladder ejection fraction of less than 35% is associated with chronic acalculous cholecystitis in 94% of patients and is a fairly good predictor of a favorable symptomatic response to surgery.

Visualization of the biliary system with non-visualization of the gallbladder after 4 hours is considered diagnostic of acute cholecystitis,But in your case gall bladder is fully visible hence it is not acute cholecystitis.The overall sensitivity of HIDA for the diagnosis of acute cholecystitis is greater than 95-98%.
However The majority of patients with chronic cholecystitis exhibit normal visualization of the gallbladder (85-90%),However the sensitivity of the test to rule out Chronic cholecystitis is about 70%,Hence a CT scan is done to confirm it.

In your reports
1) Your ejection fraction was critically low
2) Your Gall bladder is fully visible and motile

Hence it was not acute cholecystitis,Most likely it was chronic cholecystitis,But as HIDA scan is less sensitive to rule out chronic cholecystitis,Further investigations were done.

In case you have any other question,Feel free to ask!

Thanks
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Ramesh Kumar (27 minutes later)
Thank you for the very detailed response. I have a follow up with my primary physician next week. What questions and conversations do I need to be having with her regarding these HIDA scan results?I had a CT same day as HIDA and will attach results. I was referred to oncologist and endoscopic ultrasound with fine needle aspiration biopsy of mesenteric lymph nodes was performed. Lymph nodes were still enlarged but smaller. No melignancy was found. I also have been treated this past autumn for hyperparathyroidism cause by low vitamin D. I also show low calcium, protein, and albumin on blood work in August and November. I continue to experience moderate to severe abdominal pain.
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Answered by Dr. Ramesh Kumar (1 hour later)
Brief Answer:
Details below!

Detailed Answer:
Hi again.
Please mention about the problem for which HIDA scan had been suggested to you ,as the questions to be asked with your primary physician depends on what he was suspecting and what were your presenting symptoms were.Referring to oncologist and FNAC means he was ruling out some carcinoma or malignancy,May be HIDA scan was suggested as a part of that investigation only.You CT scan was suggestive of adenitis and lymph node biopsy was done further to rule out carcinoma.Most likely your HIDA scan was a part of all the basic abdominal investigations.

Thank you!
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2652 Questions

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What does my HIDA report result indicate?

Brief Answer: Detail interpretation below. Detailed Answer: Hi, Thanks for choosing health care magic for your query! Before interpreting the reports first get a brief idea about what a HIDA scan is- A HIDA scan, creates pictures of your liver, gallbladder, biliary tract and small intestine.HIDA scan is a type of imaging study in which a radioactive tracer is injected into a vein in your arm.This radioactive XXXXXXX is handled by the liver like bile hence by tracking it path we can access whether organ like gall bladder and the ducts connecting it are properly functioning or not. Overall An abnormal gallbladder ejection fraction is considered less than 35% and is not affected by age.However in your case its just 16% at the end of 60minutes.A gallbladder ejection fraction of less than 35% is associated with chronic acalculous cholecystitis in 94% of patients and is a fairly good predictor of a favorable symptomatic response to surgery. Visualization of the biliary system with non-visualization of the gallbladder after 4 hours is considered diagnostic of acute cholecystitis,But in your case gall bladder is fully visible hence it is not acute cholecystitis.The overall sensitivity of HIDA for the diagnosis of acute cholecystitis is greater than 95-98%. However The majority of patients with chronic cholecystitis exhibit normal visualization of the gallbladder (85-90%),However the sensitivity of the test to rule out Chronic cholecystitis is about 70%,Hence a CT scan is done to confirm it. In your reports 1) Your ejection fraction was critically low 2) Your Gall bladder is fully visible and motile Hence it was not acute cholecystitis,Most likely it was chronic cholecystitis,But as HIDA scan is less sensitive to rule out chronic cholecystitis,Further investigations were done. In case you have any other question,Feel free to ask! Thanks