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RUQ ULTRASOUND

INDICATIONS:

Medical Necessity: Evaluate for gallstones and dilated common bile duct and sonographic signs or cholecystitis, such as “positive sonographic Murphy’s sign,” thickened gall bladder wall, and pericholecystic fluid

Structures studied: Gallbladder (GB), common bile duct

REQUIRED IMAGES

Short Axis, Long Axis, Common Bile Duct

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HOW TO SCAN - RUQ

1.) Obtain a video clip of the GB in it’s entirety, in both the longitudinal and transverse planes.

 

2.) Obtain a static image of the GB in the transverse plane with a measurement of the anterior GB wall.

TRANSVERSE VIEW OF GALLBLADDER

TRANSVERSE VIEW OF GALLBLADDER

ANTERIOR WALL MEASUREMENT IN THE TRANSVERSE PLANE

ANTERIOR WALL MEASUREMENT IN THE TRANSVERSE PLANE

3.) Obtain a static image of the Common bile duct (CBD).

COMMON BILE DUCT MEASUREMENT

COMMON BILE DUCT MEASUREMENT

 

CRITICAL MEASUREMENTS

COMMON BILE DUCT

  • <5mm-normal in patients up to age 50 (Add 1 mm for every decade of life thereafter)

  •  5-7mm equivocal

  •  >7mm-dilated

GALLBLADDER WALL

  •  <3mm-normal

  •  3-4mm-equivocal

  •  >4mm-dilated

Note: The left lateral decubitis, in addition to the supine position, is generally superior for the GB and CBD visualization.


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OTHER RESOURCES

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