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With sphincter of oddi dysfunction, there is increased time to hepatic peak, delayed biliary visualization, delayed clearance of radiotracer from the dilated bile ducts, and prolonged biliary to bowel transit. The most common indication is acute cholecystitis, for which it is more sensitive and specific than us imaging. Fourteen healthy volunteers underwent two separate cholescintigraphic studies with and without cck treatment.
The typical cholescintigraphic imaging findings with low grade obstruction are good hepatic uptake, normal secretion into biliary ducts, and filling of the gallbladder, however, poor clearance from biliary ducts and delayed transit into the small bowel (figure 4). Hepatobiliary scintigraphy has a wide range of clinical applications, including chronic cholecystitis, biliary obstruction, and bile leak They all manifest on hida imaging as a partial biliary obstruction, eg, delayed clearance of the biliary ducts and delayed clearance into the small bowel
Hida imaging can be used as a screening test before proceeding to more invasive procedures such as ercp.
Among patients with delayed biliary to bowel transit, patients with hepatocellular dysfunction had worse mean transit time followed by patients with retention in dilated ihbr followed by retention at anastomotic site.
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