Lectures on diagnostic ultrasound Uzm.Dr. BAHRİ YILDIZ Uzm.Dr.M.EROL YAYLA
<ul><li>Saggital sonogram of the gall bladder shows multiple, echogenic, non-mobile foci without posterior shadowing, located in the wall </li></ul>
Marked wall thickening of the extrahepatic bile duct is noted.
Transverse section through the liver at the level of the hepatic veins, showing 2 curvilinear, parallel, echogenic lines coursing through the vein, identified as the TIPS stent .
Sagittal view of the liver demonstrates a large multi-cystic mass occupying most of the right lobe. The liver is enlarged
Transverse view of the right lobe, revealing a multi-cystic mass.
Transverse view of the right lobe of liver, demonstrating the anterior branch of the right portal vein entering the mass. The echogenic tissue appears to be the compressed liver parenchyma.
Transverse scan demonstrating a thickened gallbladder wall, with cholelithiasis. The gallbladder wall shows alternate hypo and hyperechoic layers. The patient was very tender while scanning .
Sagittal scan demonstrating a distended gallbladder with multiple, mobile calculi that shadow. The gallbladder wall is significantly thickened. No pericholecystic fluid is seen.
Transverse view showing the laminated appearance of the gallbladder wall.
There is very minimal intrahepatic biliary tree dilatation
The gallbladder is distended and shows layering of multiple, brightly echogenic calculi which show dense shadowing. The gallbladder wall is greatly thickened [9 mm]. Patient had focal tenderness over the gallbladder while scanning .
The transverse view shows the thickened gallbladder wall and the lumen filled with multiple gallstones .
An elongated, well defined, heterogeneously hypoechoic lesion is seen in the hepatic parenchyma.
The well defined hypoechoic lesion is seen again anterior to portal vein bifurcation. There was no flow noted in this lesion on color Doppler [image not shown here ].
The liver shows a coarse echotexture with a nodular surface and poor through transmission of sound. These findings are consistent with changes of cirrhosis. Also noted is ascitic fluid surrounding the liver .
The gallbladder shows a large calculus with posterior shadowing . The walls of the gallbladder appear thickened and indistinct, and exhibit scattered punctate high-amplitude echoes, suggesting emphysematous cholecystitis .
The gallbladder with calculus is again demonstrated. No portion of the gallbladder lumen can be reliably identified. There was tenderness over the area with transducer pressure while scanning
Two gallbladders are noted, having nearly mirror image shapes.
Transverse images right upper quadrant In these images the two gallbladders appear to arise from a common cystic duct .
Follow up scan of the patient after a fatty mealThis image shows the normal physiological contraction of both the gallbladders after a fatty meal. [compare with image 1 and
There is evidence of intrahepatic biliary dilatation. The visualized liver parenchyma appears normal.
Non shadowing mobile calculi are seen in the gallbladder