Learning objectives
Review the ultrasonographic findings of gallbladder disorders (GD),
using the ultrasound artifacts to explain them.
Provide correlation between sonographic and pathologic findings in patients with GD.
Establish the advantages of ultrasound as a first-line imaging examination in the assessment of patients with suspected gallbladder pathology.
Background
Right upper quadrant (RUQ) pain is a very common symptom at emergency departments,
being frequently associated with gallbladder disease.
For the majority of patients,
ultrasound is the preferred initial examination,
with acute cholecystitis (AC) being the major diagnostic concern.
[1]
Ultrasound has a sensibility and specificity of 88% and 80%,
respectively,
for acute cholecystitis,
and of 84% and 99% for gallstones [2].
Although there are a significant number of false positives results for AC,
the majority of those patients have symptomatic gallstones and thus would...
Findings and procedure details
Gallbladder pathology is most commonly non-neoplastic,
including common disordersas gallstones,
acute and chronic cholecystitis and cholecystosis (adenomyomatosis and cholesterolosis).
Much more uncommon is the neoplastic pathology,
that can be either malignant,
more frequently gallbladder adenocarcinoma,
orpotentially malignant,
as adenomas.
( Fig. 2 )
The imaging findings were reviewed,
with a sonographic-pathologic correlation,
based on the acknowledgement of basic concepts about the interaction between ultrasound and tissue.
1. Non-neoplastic - Common
• Gallstones -Intraluminal structures that are [3,6]:( Fig. 3 )
Echogenic
Mobile
Associated with an...
Conclusion
Ultrasound remains the first-line examination when agallbladder disorder is suspected,
because of its multiple advantages,
as the lack of ionizing radiation,
great availability,
short study time,
morphologic evaluation and the possibility of identifying associated biliary pathology and alternative diagnosis.
[1]
At emergency departments,
ultrasound allowsthe identification of acute cholecystitis and its more advanced/dangerous forms,
as gangrenous and emphysematous cholecystitis.
Thus,
the radiologist must be able to recognize its sonographic findings so that treatment can be initiated as soon as possible.
Also important is to be...
Personal information
Ana Catarina Silva (A.
Silva)- Radiology Attending at Hospital Pedro Hispano
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