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GI system NMTCB review Questions and Answers 2024
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GI system NMTCB review
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GI system NMTCB reviewWhich lobe is larger in the liver? - answer right lobe
What are the RE cells responsible for? - answer Phagocytosis
What dose/ imaging is used for liver/ spleen imaging? - answer5-10 mCi Tc-99m Sulfur
colloid (phagocytosis of RE cells MOL)
What needs to be known about a patient prior to liver/spleen imaging? - answer Lab
values (bilirubin, liver enzyme, alkaline phosphate, protein levels, prothrombin time,
urine bilirubin), previous abdominal surgery, use of barium or contrast agents
What imaging can be done for Liver/ Spleen Imaging? - answer Flow study to show
vascularity, static imaging begins 10-15 min post tracer administration (ANT, POST,
RLAT, LLAR, RAO, LAO, LPO), ANT is taken with a marker on right costal margin
SPECT imaging can tak e place to assess, size, location, and dpeth
What is Reidals lobe? - answer Greatly enlarged right lobe that extends into the pelvis
What view is the left lobe and spleen better imaged in? - answerAnterior position
What happens when there is a colloid shift during liver/spleen imaging? -
answerVisualization of the bone marrow of increased tracer concentration in the spleen
What is the sphincter of Oddi? - answeropens and closes common bile duct entrance
into the duodenum
When is bile released from the gallbladder? - answerafter a fatty meal, aids in digestion
What is CCK? - answerHomrome produced by the duodenum that stimulates the
gallbladder to secrete bile when fatty foods enter the duodenum
What is the dose used for hepatobiliary imaging? - answer2-8 mCi mebrofenin,
disofenine and lidofenend (Tc-99m IDA)
What is tracer uptake depended on in hepatobiliary imaging? - answerchemical
structure of IDA, hepatic blood flow, bilirubin level
What is the patient preparation for hepatobiliary imaging? - answerNarcotics (relaxes
the sphincter of oddi) discontinued for 6-12 hours
NPO 2-4 hours before tracer administration
, How do you image for hepatobilliary imaging? - answerAfter tracer is administered,
imaging can begin
-LEAP or parallel hole collimator is used
- Liver should be in upper left corner of the FOV
- Sequential 5 min images are acquired for 45-60 min
- If gallbladder or biliary ducts are not visualized, delayed images will be obtained
Why would sincalide (kinevac) be used? - answerUsed in patients who have faster for
more than 24 hours prior to imaging, and when the gallbladder is full at the befinning of
hepatobiliary imaging
- Helps determine the GBEF
What is the dose of sincalide (kinevac)? - answer0.01 ug/kg over 3-5 min or infused for
30-60 min if patient has faster
After the administration of CCK when does the gallbladder begin to empty? - answer2
min
What is a normal GBEF? - answer35% (less than 35% mean acalculous cholecystitis)
How do you calculate the GBEF? - answer= (max GB counts- bkg)-(min GB counts-
bkg)/ max GB counts- bkg
Why would morphine be used in hepatobiliary imaging? - answerIf the gallbladder is not
visualized within 40-60 min after tracer administration, this causes contraction of the
sphincter of oddito increase pressure in the bile duce to get into the gallbladder
What is the diagnosis if after the administration of morphine, you still cant see the
gallbladder? - answerThe patient has acute cholecysitis
What is the dose of morphine? - answer0.04-0.1 mg/kg over 2-3 min
What is Phenobarbital used for in hepatobiliary imaging? - answerAids the
differentiation of biliary atresia (blackage of tube form the liver to the gallblader) from
neonatal jaundice
What is the dose of phenobrabital? - answer5 mg/kg/day for 3-5 day before studye to
enhand the excretion of the tracer with patients with patent bile ducts
When should visualization of the hepatic ducts and the gallbladder be seen? -
answer15-30 min post tracer administration
When would delayed images of the gallbladder make sense? - answerWhen the patient
has chronic cholecystitis
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