Bladder ultrasound

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Background

  • Identification: anechoic (black) fluid within a structure defined by hyperechoic (white) appearing borders
  • Bladder volume = length x width x height x 0.52[1]

Technique

  • Phased array or Curvilinear
  • Suprapubic: look both transverse and sagittal
    • Usually need to turn down far gain 2/2 acoustic enhancement from bladder
  • Color over the inferior border can demonstrate ureteral jets
    • Twinkle Sign: rapid alternation of color immediately behind a stationary echogenic object, acquiring a false appearance of movement
      • Can indicate stone in the UVJ
  • Lack of jet on one side can indicate ureteral obstruction
  • Anechoic (black) fluid outside the bladder: Free Fluid
    • Look for 'pointy edges:' increases suspicion for fluid not in another structure (cyst, ovary, bowel, etc)

Clinical Uses

  • Look for free fluid (abdominal or pelvic)
  • Can be used to calculate post void residual non-invasively
  • Confirm foley placement by visualizing balloon
  • Ureteral obstruction
  • Nephrolithiasis in the UVJ
  • Possible to see ectopic pregnancy

Source

  1. ↑ Dicuio M et al. Measurements of urinary bladder volume: comparison of five ultrasound calculation methods in volunteers. Arch Ital Urol Androl. 2005 Mar;77(1):60-2.


See Also

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