Monday May 21 , 2012
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Ultrasound - Gallbladder

ULTRASOUND - GALLBLADDER

Alternative Names:  gallbladder ultrasound, gallbladder sonography, ultrasound of the gallbladder

PATIENT PREPARATION FOR GALLBLADDER ULTRASOUND

  • Assess supine

  • left lateral decubitus and erect

  • Use the liver as a window especially when rolling the patient onto their left side.

EQUIPMENT SET UP

  • Narrow the dynamic range and use harmonics

  • Use the highest frequency probe initially such as 7 or 8MHz then come down in frequency if required.

PATHOLOGY

  • Gallstones/cholelithiasis- check for mobility of stones or sludge by rolling patient and standing them erect.

  • Sludge

  • Cholecystitis: Acute calculus cholecystitis and acalculus cholecystitis.

  • Pericolic fluid collections

  • Adenomyomatosis "strawberry gallbladder". Rokitansky-Aschoff (R-A) sinuses are pathognemonic.

  • Gallbladder Cancer

  • Polyps or any intraluminal masses.

  • Cholesterol cystals in the GB wall

PITFALLS AND VARIATIONS OF THE GALLBLADDER 

  • If the patient has ascites, there is often reactive thickening of the GB wall.

  • A phrygian cap should not be confused with a mass or R-A sinus.

  • Folds in the wall may mimic polyps.

  • If prolongued illness, fasting and inactivity, biliary stasis will be seen as echogenic/complex bile/sludge in the GB

GALLBLADDER ULTRASOUND SAMPLE PROTOCOL (TYPICALLY)

This sample protocol is meant for educational purposes and the exact technique will depend on the patient's clinical indication for the examination and the radiologist's guidance.

  1. If there is any gross liver, pericholecystic, or abdominal pathology, document it.

  2. Measure the liver long axis and short axis for a total of 3 measurements.

  3. If there are calculi, moe the patient as see if they are mobile.

  4. If the is point tenderness, document that on the ultrasound text field and show where the point tenderness occurs.

  5. If there is a sonographic murphy sign (pain when removing pressure) document it on the image.

  6. If there is gallbladder wall thickening, (> 3 mm), measure it.

  7. If there are are polyps or masses, measure them in 3 dimensions with doppler (power doppler usually).

  8. Measure the common bile duct at the level of the portal triad.  Use flow to show it is not the portal vein or hepatic artery.

  9. Measure the common bile duct and mid-level.

  10. Measure the common bile duct at the pancreatic head.

Schedule Your Gallbladder Ultrasound Today! 

  • If you are looking for professional radiology services at your imaging site/center, call us at 1-800-626-8315 or contact us for a consultation. 

  • If you live in Los Angeles, Century City, Glendale, Mid-Wilshire and need to schedule a radiology examination such as a MRI, CT Scan, Ultrasound, X ray, or PET scan, contact us to schedule an appointment. 

  • If you are in search of other things, we're surprisingly resourceful!  Call us 1-800-626-8315 or contact us via our contact form.
  • ultrasound-gallbladder
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  • gallbladder ultrasound, gallbladder sonography, ultrasound of the gallbladder
  • Ultrasound of the gallbladder informational page including patient preparation for gallbladder ultrasound, equipment set up, gallbladder pathology, pitfalls and variations of the gallbladder, and images to obtain for the gallbladder.
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