New PDF release: Abdominal Ultrasound - How, Why and When

By J. Bates

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There is absolutely no substitute for regular practical experience under the supervision of a qualified ultrasound practitioner. There are, however, some general approaches which help to get the best from the scanning procedure: ● ● Scan in a systematic way to ensure the whole of the upper abdomen has been thoroughly interrogated. 1 Always scan any organ in at least two planes, preferably at right angles to each other. This reduces the risk of missing pathology and helps to differentiate artefact from true pathology.

After fasting for around six hours, it should be distended with bile into an elongated pear-shaped sac. The size is too variable to allow direct measurements to be of any use, but a tense, rounded shape can indicate pathological, rather than physiological dilatation. Because the size, shape and position of the gallbladder are infinitely variable, so are the techniques required to scan it. 0 MHz or higher is especially useful for anterior gallbladders. ● Use a high line density to pick up tiny stones or polyps (reduce the sector angle and the frame rate if possible).

5 The diameter increases with deep inspiration and also in response to food and to posture changes. An increased diameter may also be associated with portal hypertension in chronic liver disease (see Chapter 4). An absence of postprandial increase in diameter is also a sign of portal hypertension. The normal portal vein (PV) waveform is monophasic (Fig. 26) with gentle undulations which are due to respiratory modulation and cardiac activity. This characteristic is a sign of the normal, flexible nature of the liver and may be lost in some fibrotic diseases.

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Abdominal Ultrasound - How, Why and When by J. Bates

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