HIDA Scan With Ejection Fraction / Understanding The Results

[Guest guest]

Kathleen,

You wrote, " Question on the hida, if someone functions at 33%, what does

that REALLY mean? "

Your question actually refers to the Ejection Fraction, not the HIDA, per

se, though the EF cannot be done without the HIDA. When referenced with the HIDA

Scan, the gallbladder ejection fraction test may be done to see how much

bile leaves the gallbladder when it contracts (squeezes) and empties. This test

may also be called cholecystokinin

(koh-lee-sis-toh-KEYE-nin)-choleskintigraphy (koh-lee-skin-TIG-rah-fee), or

CCK-CS.

The reason this test is important is that when a patient presents with

biliary type pain, if there are gallstones, an ultrasound of the abdomen will

usually detect them. However, in some cases, there are no stones found in the

gallbladder, a condition termed acalculous (a-cal-koh-lus) biliary pain (ABP).

While the cause of ABP is unknown, one theory is that microscopic stones (too

small to be seen on ultrasound, yet big enough to obstruct the cystic duct)

are present. Another theory is that the pain stems from an abnormality in the

gallbladder muscle, which affects the way that it empties.

The test used to diagnose ABP is known as gallbladder ejection fraction or

Hida Scan with Ejection Fraction. In this exam, a radioactive marker is

injected into the patient and the marker is then taken up by the liver and

gallbladder. A hormone, known as CCK, is then given via IV to stimulate the

gallbladder to contract and empty. The size of the gallbladder is measured both

before

and after the CCK is given. The amount of the marker that leaves the

gallbladder is called the ejection fraction.

In people with normal gallbladders, the ejection fraction ranges between

35-75 percent. Patients who suffer from bouts of biliary pain and have lower

ejection fraction readings are assumed to have ABP. Studies have shown that

surgical removal of the gallbladder (cholecystectomy) helps ABP patients more

than 90 percent of the time. When gallbladders removed from such patients are

examined, most show the signs of chronic inflammation typically seen in

gallbladders that do contain stones.

The results of a HIDA Scan are usually written in a dictation form

describing the flow of bile through the biliary system. The results from the

Ejection

Fraction part of the diagnostic procedure are written in terms of percents,

as in what percent of the 'marker' material injected and absorbed by the

gallbladder is ejected (or squeezed) out by the gallbladder muscle when it

contracts.

Your report states that your EF was 33%. That, of course, is borderline for

possible tiny, tiny stones, or poor gallbladder muscle function.

Karyn E. , RN

Executive Director, PAI

Indianapolis, Indiana