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== HIDA scan (Hepatic IminoDiacetic Acid) == * Doesn't provide anatomic information or see gallstones, but evaluates the physiologic secretion of bile * Iminodiacetic acid is processed in the liver and secreted with bile * Failure to fill the GB two hours after injection indicates obstruction of the cystic duct (acute cholecystitis) * Will also identify CBD obstruction and bile leaks * Administration of a fatty meal/injection of CCK during the scan can be used to identify biliary dyskinesia - an ejection fraction of <35-40% is considered abnormal, but not diagnostic. False positives can be seen in diabetes, obesity, cirrhosis, etc. Re-image about 45 minutes after fatty meal to calculate EF. Normal study: Acute cholecystitis (no GB filling): GB dyskinesia (no emptying of GB):
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