Ultrasound: a practical approach to clinical problems by Peter H. Arger, Carol B. Benson, Edward I., M.D. Bluth,

By Peter H. Arger, Carol B. Benson, Edward I., M.D. Bluth, Peter, M.D. Arger, Carol Benson, Philip W. Ralls, Marilyn J. Siegel

This new textbook specializes in the function of ultrasound and the workup of usually encountered scientific difficulties. Written by way of a exceptional te am of radiologists, it presents precise assurance of the strengths and boundaries of grey scale, colour, and Doppler sonography, and contro versial components in ultrasound prognosis. Chapters are divided into clin ical indicators, giving radiologists easy accessibility to the knowledge they want. every one bankruptcy is followed through an in-depth research which incl udes a differential analysis, diagnostic workup, and the position of ultr asound may still play within the particular scientific challenge.

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3rd ed. Philadelphia: WB Saunders; 1991:174–185 8. Wiener SL. Acute right hypochondriac pain. In: Wiener SL, ed. Differential Diagnosis of Acute Pain by Body Region. 1st ed. New York: McGraw-Hill; 1993:217–226 9. Barakos JA, Ralls PW, Lapin SA, et al. Cholelithiasis: evaluation with CT. Radiology 1987;162:415–418 10. Gelfand DW, Wolfman NT, Ott DJ, et al. Oral cholecystography vs gallbladder sonography: a prospective, blinded reappraisal. AJR Am J Roentgenol 1988;151:69–72 11. Berk RN. Oral cholecystography.

122 Relation of Ultrasound Imaging to Other Imaging Modalities As the number of available imaging modalities used to evaluate jaundice continues to expand, clinical and imaging guidelines are becoming increasingly important (Fig. 2–18). In general, ultrasound imaging has been and continues to be the initial imaging modality of choice for evalu- Figure 2–18 Algorithm for workup of jaundice. CT, computed tomography; ERCP, endoscopic retrograde cholangiopancreatography; MRCP, magnetic resonance cholangiopancreatography; PTC, percutaneous transhepatic cholangioscopy; Rx, prescription.

B) Sagittal scan in a different patient shows pneumobilia in the common bile duct (arrows). Accuracy of Ultrasound Imaging As a screening modality, the primary role of ultrasound imaging is to determine if biliary dilatation is present. Because ultrasound imaging is operator dependent, considerable variation exists in its ability to depict biliary obstruction. 104 The secondary role of ultrasound imaging is to determine the specific level and cause for an obstruction. 105 It is important to identify the anatomical site and cause of an obstruction because this information may determine what other imaging examinations may be required for diagnostic evaluation.

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