- What is echogenicity?
- Norm of ultrasound examination of the gallbladder
- Causes of anechoemia of the gallbladder
- Rules for the preparation and preparation for ultrasound examination of the gallbladder
- Related Videos
Ultrasound examination of the gallbladder can be performed both independently and in complex visualization of the abdominal cavity organs. The procedure is prescribed if there is a symptomatology indicating the development of cholelithiasis pathology or other diseases. In the interpretation of the results, the phrase "anechogenous contents of the gallbladder" is sometimes encountered. What is hidden behind this concept?
It is important to remember that an ultrasound specialist does not make a diagnosis, but only describes the picture he has seen and makes assumptions. Deciphering the results obtained and their subsequent interpretation is handled by the attending physician.
What is echogenicity?
Echogenicity is understood as the ability of living tissues to repel ultrasound waves transmitted by the apparatus. Human organs on the monitor look in the form of light or dark spots. Color depends on the ability to absorb or reflect ultrasound.
Bones, gases and collagen belong to hyperechoic objects. They are able to reflect the main part of the rays. On the monitor they are defined as zones of saturated white color. Hypoechoic are all soft tissues. They reflect only part of the ultrasound, absorbing its residues. The specialist sees them as spots of all shades of gray.
Anehogenicity - not the ability to repel ultrasonic waves - has fluids. On the monitor they look like completely black zones. Quite often the doctor uses the term in the case when he can not make out what he sees on the screen. Diagnosis in this case will deal with the doctor in charge. It is likely that a person will be assigned additional research.
In some cases - if additional changes in the organ are detected - the ultrasound specialist may indicate probable variants of what may be hidden behind anehogennym content.
It is also important to remember that this term describes different types of formations. For example:
- liquid filled capsules;
- blood streams;
- neoplasms of increased density and others.
Due to the fact that anechoic formation visually looks like a dark spot, a physician can accurately calculate its true size, which greatly facilitates the formulation of the final diagnosis
Norm of ultrasound examination of the gallbladder
The gall bladder looks like a pear. The organ has three parts:
- Bottom. Wide edge, slightly protruding for hepatic tissues.
- Body. The main part of the bubble, which acts as a storage ring.
- Neck. The narrowing part of the bile, through which the accumulated bile is excreted.
The gallbladder is a hollow sac-shaped organ in which bile is collected. Ultrasound is always performed on an empty stomach. This allows to preserve the fullness of the organ necessary for qualitative examination: the specialist is able to assess the condition of the walls and liquid contents.
The following indicators are the norm for a healthy body:
- pear shape;
- length - 8-14 mm, width - 3-5 mm;
- is located inside the liver, outside is only the bottom of the gallbladder;
- no irregularities have clear contours;
- wall thickness - no more than 3 mm;
- the contents are homogeneous anechogenous.
Any violation, including anehogenicity, is recognized by doctors as a sign of the development of a pathological condition. Thickening of the walls of the organ occurs as a result of inflammation. With the development of cholelithiasis and pathological conditions, accompanied by the formation in the cavity of the gallbladder stones or other formations, violates the anehogenicity of bile. It becomes echogenic.
Causes of anechoemia of the gallbladder
The organ is almost always filled with bile. In addition to it, no other inclusions should be present in the cavity. If bile is not visualized as an anechoic substance, this means that it contains extraneous formations. Then on the screen of ultrasound on a background of black spots appear lighter shades.
Examples of anechogenicity disorders that are diagnosed by ultrasound
Depending on the nature of the change in echogenicity, there may be:
- focal - most often it is a cluster of worms or stones;
- diffuse - represented by precipitation, blood or pus.
Quite often, parasites settle inside the gallbladder. They are found mainly in childhood. In addition to the violation of anehogenicity, the patient has the following symptoms:
- thickening of the walls caused by the inflammatory process;
- congestion of bile caused by clogging of excretory ducts;
- Parasite aggregates are defined as bright formations.
In addition to ultrasound signs, the patient develops a characteristic clinical picture. This deterioration of the general condition, problems with the work of the digestive tract, the appearance of a yellow shade of the skin and mucous membranes.
The next cause of the violation of the echogenicity of the gallbladder is the formation of concrements. They differ not only in chemical composition, size and form, but also in origin. It is accepted to distinguish the following varieties of concrements:
The composition of the calculus, relying only on the result of ultrasound diagnostics, can not be determined
The task of diagnosis is to identify the type of stone depending on the level of echogenicity. Weak-echogenic stones: such stones have a loose structure, which is typical for cholesterol varieties. Formations of this type are easily destroyed by medication.
To confirm the diagnosis - at least indirectly - during the procedure the patient changes the position of the body.
If this really is a concrement, then they continue to remain inside the organ and can move inside the anechogenous contents (bile). Polyps remain attached to the wall of the bladder.
Stones of medium and high echogenicity: most often these are pigmented and calcareous concretions. Visualized as bright white spots against the background of dark bile. A typical sign is a cast shadow.
In cholelithiasis, ultrasound diagnostics reveals stones that give a general acoustic shade. This symptom indicates the presence of either one large, or many small concrements, which completely overlap the lumen of the bile ducts.
Changing the wall thickness of the gallbladder is the next reason for the violation of anehogenicity of the contents of the organ. Thickening can occur as a result of the presence of sediment, pus or blood. These substances are capable of evenly reflecting ultrasonic radiation, mixing with bile.
The signs are:
- Sediment is always determined at the bottom of the bubble. It lies in a uniform layer, and above it anechoic zone, represented by pure bile, is determined.
- When there is purulent content in the cavity of the organ, at first it resembles a sediment. But after changing the position of the patient's body, it is mixed with bile. In the case of a chronic suppurative process, septa that have characteristic properties, determined during ultrasound diagnosis, are determined inside the organ.
- Blood over time turns off and on the monitor looks like a thick with a weak echogenicity. Visually they are similar to polypous formations or concrements.
Purulent melting is a complication of cholecystitis
Inside the gallbladder, other echogenic neoplasms are detected. A typical difference is the presence of attachment to the wall: they do not move when the patient changes his body position. To such include cholesteric polyps. They can reach 4 mm in height and are distinguished by the presence of a homogeneous structure. The polyp has a wide base, and the neoplasm itself distinguishes even outlines.
Another common cause of anechoic disorders is the formation of tumors that can be both benign and malignant. They differ in the degree of germination of the wall of the bladder: benign neoplasms do not affect all the muscle layers of the organ, malignant tumors germinate and later as a result of necrosis of the gallbladder walls it ceases to be determined during ultrasound examination.
Benign tumors include:
To reveal the goodness of the tumor only by the results of ultrasound diagnostics is almost impossible. It will be necessary to conduct differential diagnosis with stones, polyposis and cancers.
Malignant tumors lead to a change in the visual image of the gallbladder. At first, its walls become uneven, and then are not determined at all. The neoplasm is attached to one of the surfaces of the organ. If the position of the body changes during the diagnostic procedure, it always remains in one place.
Rules for the preparation and preparation for ultrasound examination of the gallbladder
To get the most reliable results, the procedure must be prepared.
Properly conducted training will allow the specialist to get more accurate results
Here are a few simple rules:
- a week before the planned procedure, you must abandon alcohol, fatty foods and products that cause increased gas production - sweet carbonated drinks, buns, legumes, vegetables and fruits in fresh form;
- for three days before the ultrasound, you need to start taking Mezim;
- last time allowed to eat (light dinner) 8 hours before the study.
If the diagnosis is carried out in the morning, then you can not drink even water. When the procedure is scheduled for the afternoon, a light breakfast is allowed. Anechogenous content, defined in the gall bladder, is the physiological norm. It indicates the fullness of the body with bile, which has no sediment or pathological inclusions.