Biliary ultrasound: Difference between revisions
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==Measurements== | ==Measurements== | ||
*GB wall is | *GB wall is <4 mm + 1 mm/decade | ||
**Measure the | **Measure the anterior wall at narrowest point with a short-axis view | ||
**Causes: | **Causes: | ||
***1. Acute cholecystitis | ***1. Acute cholecystitis | ||
Line 25: | Line 25: | ||
**identify by hypoechoic "shadowing" behind hyperechoic stones | **identify by hypoechoic "shadowing" behind hyperechoic stones | ||
***if no shadowing, may be polyps, sludge, etc. | ***if no shadowing, may be polyps, sludge, etc. | ||
**SIN Sign: Stone-in Neck | |||
*Common Bile Duct | *Common Bile Duct | ||
**Measure from inner to inner | **Measure from inner to inner | ||
**Normal is up to | **Normal is up to 4 mm to age 40 (add 1mm per decade thereafter) | ||
**Mickey Mouse Sign: Portal Vein (face), CBD (right ear), and hepatic artery (left ear) | |||
***Color doppler will demonstrate the vein and artery | |||
*Acalculous cholecystitis | *Acalculous cholecystitis |
Revision as of 19:06, 31 December 2014
Technique
- Can use phased array or convex probe
- Look in midclavicular line at Right 11th/12th intercostal spaces or scan anteriorly from Morrison's pouch
- Patient in Left lateral decubitus (if can tolerate)
- Allow for better visualization of gallbladder (moves gallbladder anteriorly)
- Better visualization of gallstones
Findings
Evaluate gallbladder for:
- GB wall measurement
- Pericholecystic free fluid
- Gallstones
- Common Bile Duct (CBD) measurement
- Sonographic Murphy's (pain with ultrasound probe palpation over gallbladder)
Measurements
- GB wall is <4 mm + 1 mm/decade
- Measure the anterior wall at narrowest point with a short-axis view
- Causes:
- 1. Acute cholecystitis
- 2. Ascites
- 3. CHF
- Gallstones
- identify by hypoechoic "shadowing" behind hyperechoic stones
- if no shadowing, may be polyps, sludge, etc.
- SIN Sign: Stone-in Neck
- identify by hypoechoic "shadowing" behind hyperechoic stones
- Common Bile Duct
- Measure from inner to inner
- Normal is up to 4 mm to age 40 (add 1mm per decade thereafter)
- Mickey Mouse Sign: Portal Vein (face), CBD (right ear), and hepatic artery (left ear)
- Color doppler will demonstrate the vein and artery
- Acalculous cholecystitis
- GB is >10cm long & >4 cm wide
See Also
Source
Sonoguide