Normal sonographic appearance of the pancreas On US, the pancreas is normally homogeneous in echotexture and isoechoic to hyperechoic compared to the normal liver. Aging and obesity can result in fatty change and resultant increased echogenicity of the pancreas. The pancreatic duct is visualized on US in up to 86% of patients and normally has …
Possible causes of biliary obstruction • Choledocholithiasis. • Congenital biliary disease (choledochal cysts, Caroli’s disease). • Cholangitis with stricture formation (such as with pyogenic, helminthic, or HIV infection or with sclerosing cholangitis). • Neoplastic disease (cholangiocarcinoma, metastatic disease).
Ultrasound appearances of gallbladder carcinoma Gallbladder carcinoma can appear as a mass in the gallbladder fossa with obliteration of the gallbladder (the most common finding), can present as focal or diffuse irregular gallbladder wall thickening, or can appear as an intraluminal polypoid gallbladder mass (typically >1 cm in size with prominent internal vascularity). Contiguous hepatic invasion …
Normal caliber of the extrahepatic bile duct The normal caliber of the extrahepatic bile duct is ≤7 mm. In older patients (>60 years) and in patients who have had previous cholecystectomy, the extrahepatic bile duct may measure up to 10 mm in caliber. In general, a diameter >7 mm without cholecystectomy should at least prompt correlation with serum …
Can Ultrasound differentiate between benign and malignant gallbladder polypoid lesions (polyps)? There are both benign (cholesterol, inflammatory) and malignant (gallbladder adenocarcinoma, metastases [most commonly melanoma]) gallbladder polyps. Benign polyps are very common and are typically multiple, oval, and less than 10 mm in size. In contrast, malignant polyps are more commonly single, sessile, and greater than …
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Complications of cholecystitis and their appearance on Ultrasound Complications of cholecystitis include gallbladder gangrene, hemorrhage, perforation, and emphysema. Gangrenous cholecystitis is diagnosed on US by visualizing nonlayering bands of echogenic tissue in the lumen due to sloughed membranes and blood. The gallbladder wall also becomes more irregular with small wall collections due to abscesses or …
How does acute cholecystitis manifest on Ultrasound? The sonographic features of acute cholecystitis include gallbladder distention (>4 cm), gallbladder wall thickening (>3 mm) and hyperemia, gallstones (especially if impacted at the gallbladder neck or in the cystic duct), pericholecystic fluid, and a positive sonographic Murphy’s sign (focal tenderness over the gallbladder when compressed by the US transducer). …
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