Test with a choleretic breakfast
A regular ultrasound shows the gallbladder at rest: its size, wall thickness, the presence of stones, polyps and sediment. But a common cause of complaints is not stones, but a contractility disorder, in which the bladder either empties too weakly or contracts excessively and spastically. It is impossible to see this in a static study.
The functional test is simple. First, three bladder sizes are measured on an empty stomach and its initial volume is calculated. Then the patient takes a choleretic breakfast - usually two egg yolks or a portion of fat sour cream. The measurements are repeated after 15, 30, 45 and 60 minutes, and from them an emptying curve is constructed with the calculation of the contractility coefficient.
The result has direct clinical application. Emptying less than 40 percent indicates hypokinetic dyskinesia, in which stagnation of bile creates conditions for the formation of stones. Rapid and excessive contraction is characteristic of the hyperkinetic type with paroxysmal pain. The treatment for these options is opposite, so the trial, which takes about an hour and a half, actually changes the prescriptions, and does not just add a line to the protocol.
Ultrasound capabilities
Ultrasound remains the first choice for imaging in almost every situation: it is accessible, safe, does not require radiation, and provides images in real time. It perfectly shows parenchymal organs, fluid formations, walls of hollow organs and soft tissues, and in Doppler mode, blood flow in the vessels.
A separate advantage is the possibility of dynamic tests: the doctor can ask you to strain, change your body position, fill or empty an organ and see how the picture changes. Neither computed tomography nor magnetic resonance imaging provide such an opportunity.
What influences the quality of research
The main enemy of ultrasound is gas: it completely reflects the wave. Therefore, distended intestines can make the pancreas, aorta, and retroperitoneal structures invisible. For the same reason, preparation for examining the abdominal cavity is not a formality, but a condition for a reliable result.
Severe obesity, postoperative scars, bandages and open wounds in the area of interest also have an effect. If the picture turns out to be uninformative, the doctor indicates this in the protocol and recommends an alternative method - computed tomography or magnetic resonance imaging.
Doppler mode
Dopplerography shows the movement of blood: color mapping reflects the direction of flow, spectral analysis measures velocities and resistance indices. This allows you to assess the patency of the vessel, identify stenosis, thrombus, aneurysm, pathological reflux and the nature of the blood supply to the formation.
Increased blood flow in Doppler mode is an important sign of active inflammation or tumor growth, which is why many organ studies are supplemented with Doppler as a mandatory part of the protocol.