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Journals
Journal of Ultrasonography
Volume 20 (2020): Issue 80 (January 2020)
Open Access
Optimization of diagnostic ultrasonography of the gallbladder based on own experience and literature
Andrzej Smereczyński
Andrzej Smereczyński
,
Katarzyna Kołaczyk
Katarzyna Kołaczyk
and
Elżbieta Bernatowicz
Elżbieta Bernatowicz
| Mar 31, 2020
Journal of Ultrasonography
Volume 20 (2020): Issue 80 (January 2020)
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Article Category:
review-article
Published Online:
Mar 31, 2020
Page range:
29 - 35
Received:
Sep 06, 2019
Accepted:
Nov 13, 2019
DOI:
https://doi.org/10.15557/jou.2020.0006
Keywords
gallbladder
,
lesions
,
scanning technique
,
ultrasonography
,
differentiation
© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Fig. 1.
An entire gallbladder is clearly visible in two cross-sections due to hepatic acoustic window for all its parts
Fig. 2.
Two oblique cross-sections of the gallbladder. Its walls may be assessed only when contacting the liver. Gas in the duodenal bulb causes distinct reflections, which make it impossible to assess the gallbladder wall at this site
Fig. 3.
The arrow indicates the gallbladder fundus, which is difficult to assess as it is not covered by the liver
Fig. 4.
Gallbladder. A. Two typical cross-sections, with no detectable lesions. B. The same case. Focusing on the assessment of the gallbladder fundus allowed to identify signs of focal adenomyomatosis
Fig. 5.
An image of adenomyomatosis in the gallbladder fundus, obtained with a linear transducer. The arrows point to the Rokitansky-Aschoff sinuses
Fig. 6.
Another example of adenomyomatosis in the gallbladder fundus visualized with a linear transducer. The Rokitansky-Aschoff sinuses are clearly seen
Fig. 7.
The arrows indicate a small stone wedged in the neck of the gallbladder, which is difficult to visualize, on two cross-sections
Fig. 8.
A long (40 mm), bent cystic duct is seen on the sonogram
Fig. 9.
Difficult gallbladder assessment due to its horizontal position at the level of the costal arch
Fig. 10.
Divided sonogram. The arrow on the left points to a pseudotumor of the gallbladder fundus due to duodenal bulb compression. After a while the entire gallbladder fundus was visible, as can be seen on the right side of the image
Fig. 11.
Divided sonogram. The left-sided arrow indicates a lesion generating dirty shadow in the field of the gallbladder fundus. A segment of transverse colon with accentuated haustration (arrows), which is the cause of this acoustic phenomenon, is seen on the right side of sonogram
Fig. 12.
The measurement of the actual gallbladder wall thickness is only possible on the hepatic wall
Fig. 13.
Divided sonogram. A non-enlarged image of a polyp is seen on the left. The same polyp in a zoomed image on the right. The difference is the size is 1.5 mm
Fig. 14.
Divided sonogram. The dimensions of the same polyp in a non-zoomed image on the left and in a zoomed image on the right
Fig. 15.
Divided sonogram. Accurate assessment of shape and size of a gallbladder adenoma (right) is possible only using an enlarged image
Fig. 16.
Gallbladder. A. An image obtained in two oblique projections in supine position. Stones cannot be seen in these projections. B. The same gallbladder. Microstones were observed only in the right oblique position
Fig. 17.
Variable location of gallbladder microstones in a supine and upright position
Fig. 18.
A floating gallbladder with a stone. A. In a supine position, the gallbladder (GB) is located to the left of the aorta (A). S – Spine. B. The same gallbladder in the position on the right side. The gallbladder (GB) migrated to the right of the aorta (A)
Fig. 19.
Divided sonogram. Size and vascular pattern of a gallbladder adenoma
Fig. 20.
Divided sonogram. Vascularized gallbladder cancer mimicking a mass of biliary sludge
Fig. 21.
A. Portal vein thrombosis in cirrhosis. Gallbladder wall blood vessels were visualized with Color Doppler. B. Pulsed Wave Doppler showed venous blood flow in these vessels
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