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Radiology · Nuclear medicine
Sample itemA young woman has right upper quadrant pain and an equivocal ultrasound. A hepatobiliary (HIDA) scan is performed. Which finding supports acute cholecystitis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Non-visualisation of the gallbladder despite tracer in the bile ducts and bowel
In acute cholecystitis the cystic duct is usually obstructed, so the radiotracer excreted in bile does not fill the gallbladder. The tracer appears in the common bile duct and small bowel while the gallbladder remains unseen. Normal filling within about an hour effectively excludes acute cholecystitis.
Option by option
A. Tracer accumulation in the lungs
Lung accumulation of tracer is not part of a hepatobiliary study.
B. Prompt gallbladder filling within an hour
Prompt gallbladder filling indicates a patent cystic duct and argues against acute cholecystitis.
C. Non-visualisation of the gallbladder despite tracer in the bile ducts and bowel (correct)
Correct. Cystic duct obstruction prevents tracer from entering the gallbladder.
D. Absence of tracer in the liver
Absence of tracer in the liver would suggest severe hepatocellular failure, not cholecystitis.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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