Radiology manager
In the previous article, we revealed that physicians who suspect a patient may have gallbladder disease could, at times, find themselves in a situation where the patient presents clinically with gallbladder disease but testing has been inconclusive.
With a majority of radiologic tests, we are looking for signs of abnormalities in the anatomy to aid in the diagnosis of disease. For some patients who experience inconclusive test results, the answer may lie in a visit to the nuclear medicine department at St. Luke Hospital.
We routinely perform a test specific to the gallbladder or hepatobiliary system that will enable us to determine whether the gallbladder is functioning correctly. To perform the hepatobiliary scan, the patient is instructed to not eat or drink anything for a minimum of 12 hours before the test.
After arriving at the nuclear medicine lab, the patient will have an intravenous (IV) line inserted. The IV allows us venous access for the injection of the radioisotope and other drugs used to perform the scan.
Following the injection of the radioisotope, the upper abdominal area of the patient is scanned for a period of 30 to 60 minutes. After the technologist determines that the gallbladder is visualized and is actively filling, a second injection is performed.
The second injection is not a radioisotope, but a drug that causes the gallbladder to contract and empty. The second drug, cholecystokinase (CCK), is injected for three to four minutes and imaging is continued for approximately 30 minutes.
Although the patient does not experience any side effects to the radioisotope, the CCK may cause the patient to have mild to moderate cramping pain in the abdomen and some nausea.
When all imaging has been completed, the patient is instructed to eat a light meal and to resume normal activities. The images are processed using a computer program that will calculate the gallbladder ejection fraction or how the gallbladder reacted to the CCK injection.
To be considered normal, the gallbladder must empty a minimum of 35 percent of its contents. Any number less than 35 percent is considered abnormal and could potentially lead to removal of the gallbladder.
For more information about nuclear medicine testing or other testing performed at the St. Luke radiology department, please contact me at the hospital, (620) 382-2177.