Sonographic Measurements Gallbladder Contractions

Gallbladder Contractions
Indications:
x Suspected cystic duct obstruction
x Prior to litholysis
x Prior to lithotripsy
Measurement:
x With a planimetry unit: Measure the maximum longitudinal area by scanning points around the gallbladder circumference .
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Gallbladder planimetry for determining maximum
longitudinal area.
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Sonographic gallbladder planimetry for determining maximum longitudinal area.
L = liver, GB = gallbladder.
Without a planimetry unit: Measure the three greatest diameters in two planes and multiply them (length q depth q width) to calculate the gallbladder volume using the formula for an ellipsoid (sonographic residual urine determination.
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a Measurement in transverse section. W = width, D = depth. b Measurement in sagittal section. L = length.
Test meal: A large, fatty, nonstandardized breakfast or a standardized beverage
(e.g., 350mL of cocoa).
Procedure:
x The gallbladder is measured in the fasted patient (see above).
x The patient consumes a fatty breakfast (e.g., rolls with butter and cheese, 1 egg, and 1 cup of hot chocolate).
x The measurements are repeated at intervals of approximately 10min.
Findings:
x More than a 50% decrease in gallbladder volume indicates a significant contraction. Gallbladder contractions are maximal at 30–45 min.
x Contractions are absent or deficient in patients with cholecystitis, cystic duct obstruction, hepatic cirrhosis, diabetes mellitus, pregnancy, or celiac disease.
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