Liver Imaging
How do the early images and the delay images look for an RBC Liver Scan for a Hemangioma?
What is: On early images the hemangioma will appear cold and on delay images (2 hours later) the hemangioma will appear hot.
What would be an indication for performing spleen imaging with Tc99m sulfur colloid?
"To look for enlargement of the spleen (splenomegaly)."
This leads to a "chronic cholecystitis" diagnosis.
What is "Delayed gallbladder visualization after 60 minutes, visualization of the small bowel before visualization of the gallbladder at 60 minutes, or decreased gallbladder ejection fraction."
Some or all of the ducts aren't formed correctly, are damaged, or are missing.
What is biliary atresia.
Name 2 RRx used for GI bleeds
Tc99m-SC and Tc99m-RBCs
On an Liver scan for a hemangioma, what will the images look like if the patient is injected with SC instead of tagged RBCs?
The images will be photopenic with SC and not with tagged RBCs.
The principle behind imaging with heat damaged RBCs is?
What is "The damaged RBCs are promptly removed from the circulation by any functioning splenic tissue present." They are preferentially sequestered by splenic tissue.
"Gallstone impaction and obstruction of the cystic duct with associated inflammation of the gallbladder wall." is the cause of__________.
In most cases, what is acute cholecystitis?
This is a major diagnostic finding on hepatobiliary imaging seen in neonates with biliary atresia.
What is "No visible gut at 24 hours".
Acute or Intermittent: Which type of bleed do I use Tc99mSc?
Acute/Active
This occurs when the patient is injected with Tc99m sulfur colloid for a Liver/Spleen scan.
The Tc99m sulfur colloid is rapidly phagocytized by the RES (reticuloendothelial cells) of the liver, spleen, and bone marrow.
An indication to do a Heat Damaged Labeled RBC scan.
What is "To locate accessory splenic tissue."
A "biliary leak" is most commonly found after abdominal surgery for biliary tract disorders or abdominal trauma. What is the preparation for the patient when images are performed for a Bile Leak?
No restrictions.
Infants with suspected biliary atresia are pretreated with what medication and for how long?
What is Phenobarbital / several days
Dynamic or Static: Initial imaging for a GI bleed should be__________ for ________(time).
dynamic for at least 1 hour.
Once a patient is injected with 5 mCi of Tc99m sulfur colloid, how long do we wait for the colloidal particles to be collected in the RES before imaging?
What is 15 minutes. (This way the colloidal particles will be completely localized in the liver and spleen).
The isotope and dose for a Liver/Spleen scan?
What is Tc99m Sulfur Colloid 5 mCi.
What is the general prep for a biliary scan?
NPO for 4 hours and no narcotics for 4 hours.
The isotope and dosage used for biliary atresia is?
What is "Tc99m Mebrofenin -pediatric dose".
If I inject a patient with 99mTc-RBCs, can I scan the patient 24hrs later if needed?
Yes.
What is the patient prep for a Liver/Spleen scan? (NPO, pain meds,etc)
No restrictions
How many images are usually performed for a Liver/Spleen scan and what are they?
What is "planar (Rao/Lao, R/L lat, A/P, Rpo/Lpo and R costal marker; Spect imaging may be performed".
Morphine is given to ____________.
contract the sphincter of Oddi and cause the GB to fill after initial scanning reveals gut activity and no GB.
The prep for a biliary atresisa scan is?
There is no prep.
Positioning for a GI bleed should include________
the base of the liver and extend to the pubic symphysis (the entire abdomen)