Acoustic shadow formation by gallstones.

Gonzalez, Luiz Ricardo; MacIntyre, W.J.

doi:10.1148/radiology.135.1.7360964

Cited by 15 publications

(7 citation statements)

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“…Cholelithiasis was identified as curvilinear echogenic structures casting acoustic shadows which moved with a change in scan position[37] [38]. Biliary sludge was identified as sand-like echogenic structures in the gallbladder which move with a change in scan position but do not cast acoustic shadows[36] [37].…”

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confidence: 99%

Cholelithiasis in Children with Sickle Cell Anaemia: A Cross-Sectional Analysis from Northeast Nigeria

Ajani¹,

Jalo²,

Saad³

2019

OJPed

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Background: Nigeria contributes 30% to the global sickle cell anaemia burden. Cholelithiasis occurs commonly in children with sickle cell anaemia and may remain undiagnosed, mimic abdominal vaso-occlusive crises or become complicated by calculus cholecystitis. Early identification of children with sickle cell anaemia who have Cholelithiasis reduces the chances of misdiagnosis, mistreatment and improves outcomes. There is limited knowledge about the prevalence of Cholelithiasis among Nigerian children with sickle cell anaemia. The present study aimed to determine the prevalence of Cholelithiasis in children with sickle cell anaemia in Gombe, northeast Nigeria. Methodology: This was a cross-sectional analysis of children with sickle cell anaemia being followed-up at the sickle cell centre of the Federal Teaching Hospital, Gombe, northeast Nigeria. We consecutively recruited 294 children aged 2-17 years while in steady state from June to November 2017. Quantitative data were collected from parents/caregivers via a researcher administered questionnaire and cholecystosonography performed after a minimum of 8-hour fast. Predictors of Cholelithiasis were examined using binary logistic regression. Results: The mean age of children with sickle cell anaemia was 9.0 ± 4.5 years. The prevalence of Cholelithiasis in children with sickle cell anaemia in steady state was 4.8%. Children aged 15-17 years had 12 times higher odds of having Cholelithiasis [AOR = 12.268 (95% CI = 1.3-112.8)]. Conclusion: The prevalence of Cholelithiasis in children with sickle cell anaemia though generally low, increases progressively with age to peak during middle to late adolescence.

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confidence: 99%

Cholelithiasis in Children with Sickle Cell Anaemia: A Cross-Sectional Analysis from Northeast Nigeria

Ajani¹,

Jalo²,

Saad³

2019

OJPed

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“…We believe that following the observations made by Taylor and coworkers [19] in regard to the choice of transducer's frequency, focusing, and the overall gain used at every individual examination, as well as proper orientation of the beam [20], helped us to make the correct diagnosis in the presence of small calculi, which in 1 patient escaped even the attention of the operating surgeon (Fig. 2a-b).…”

Section: Discussionmentioning

confidence: 73%

Abdominal ultrasound in patients with acute right upper quadrant pain

Philbrick

Kaude

McInnis

et al. 1981

Gastrointest Radiol

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Ultrasonography was performed as the first imaging procedure in 100 patients who presented with acute right upper quadrant pain suggestive of cholecystitis or cholelithiasis. In the final analysis 46 patients were found to have gallbladder disease (40 patients with cholelithiasis, 5 with acalculous cholecystitis, and 1 with a cholesterol polyp in the gallbladder). In 22 of 54 patients with a normal gallbladder, other abdominal disease was found. The error rate for ultrasound was 5%, and in 4 patients ultrasound was not the suitable procedure for the diagnosis. In 91 patients the ultrasonographic diagnosis was correct.

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“…Some patients with gallstones show characteristic sonographic findings, such as acoustic shadowing and comet-tail artifacts. [12][13][14][15] Acoustic shadowing is useful for diagnosing gallstones but may limit the examination of part of the gallbladder and obscure an associated mass developed from the gallbladder wall. Although an increased incidence of gallstones in patients with gallbladder adenomyomatosis and gallbladder cancer has been reported, 16 no previous study has examined the relationship between the presence of gallstones and the diagnosis of gallbladder wall lesions.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic sonography in the diagnosis of gallbladder wall lesions in patients with gallstones

Muguruma

Okamura

Ichikawa

et al. 2001

J. Clin. Ultrasound

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Purpose. The purpose of this study was to evaluate the diagnostic accuracy of endoscopic sonography (EUS) in the detection of gallbladder wall lesions in patients with and without gallstones.Methods. We retrospectively reviewed the medical records, sonograms, and sonographic reports of 62 patients who underwent cholecystectomy for gallbladder wall lesions evaluated by EUS. We assessed the accuracy of EUS in diagnosing gallbladder wall lesions in the presence or absence of gallstones and on the basis of the size and number of stones and the size of the gallbladder wall lesions. We also evaluated the effect of acoustic shadowing. The EUS results were compared with the histopathologic results.Results. EUS correctly diagnosed the gallbladder wall lesions in 17 (71%) of 24 patients with gallstones and in 34 (89%) of 38 patients without gallstones. The diagnostic accuracy of EUS was 86% in patients with gallbladder wall lesions smaller than 20 mm and 79% in patients with gallbladder wall lesions 20 mm or larger. The diagnostic accuracy was 75% in patients with gallstones smaller than 5 mm and 67% in patients with stones 5 mm or larger. The accuracy was 67% in patients with 1-5 stones and 83% in patients with 6 or more stones. None of these differences was statistically significant. Acoustic shadowing did not affect the diagnostic accuracy of EUS.Conclusions. The diagnostic accuracy of EUS for gallbladder wall lesions is not affected by the presence of gallstones. However, better diagnostic criteria must be established based on larger studies, and technical refinements of the equipment are needed to increase the accuracy of EUS in the diagnosis of gall-bladder wall lesions.

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Acoustic shadow formation by gallstones.

Abstract: Schlieren photography of gallstones and models of gallstones made from amorphous substances has demonstrated that acoustic shadowing depends primarily on the orientation of the surface of the stone in relation to the sound beam, not the composition of the stone.

Cited by 15 publications

References 1 publication

Cholelithiasis in Children with Sickle Cell Anaemia: A Cross-Sectional Analysis from Northeast Nigeria

Cholelithiasis in Children with Sickle Cell Anaemia: A Cross-Sectional Analysis from Northeast Nigeria

Abdominal ultrasound in patients with acute right upper quadrant pain

Endoscopic sonography in the diagnosis of gallbladder wall lesions in patients with gallstones

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