RadteraUltrasound Abdomen Limited (RUQ / Gallbladder)
USNo contrastAbdomen & Pelvis
Indications
- RUQ pain
- Suspected cholelithiasis or cholecystitis
- Suspected biliary obstruction
- Abnormal liver function tests
- Follow-up of gallstones
Patient prep
- NPO 6-8 hours for gallbladder distension
Contrast
None / non-contrast
Technique
- Curvilinear 2-5 MHz transducer
- Supine and left lateral decubitus to demonstrate stone mobility
- Subcostal and intercostal windows with deep inspiration
- Assess sonographic Murphy sign with probe over gallbladder
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | Gallbladder long axis | Long axis | Stones, sludge, polyps; wall thickness (normal <3 mm) |
| 2 | Gallbladder transverse | Transverse | Fundus to neck |
| 3 | Gallbladder - decubitus / upright | Long axis | Demonstrate stone mobility vs polyp |
| 4 | Common bile duct | Long axis | Inner-to-inner diameter; normal up to ~6-7 mm |
| 5 | Liver - right lobe and adjacent parenchyma | Long axis and transverse | Echotexture; intrahepatic duct dilatation |
| 6 | Portal vein at porta hepatis | Long axis | Distinguish duct from vessel with color Doppler |
Key points
- Sonographic Murphy sign + gallstones + wall thickening + pericholecystic fluid suggests acute cholecystitis
- Pericholecystic fluid and gallbladder distension support cholecystitis
- Reposition patient to differentiate mobile stones from fixed polyps/tumefactive sludge
- Evaluate CBD and intrahepatic ducts for obstruction
References
• AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum (2022)
• ACR Appropriateness Criteria: Right Upper Quadrant Pain
• Radiopaedia: Acute cholecystitis link
• ACR Appropriateness Criteria: Right Upper Quadrant Pain
• Radiopaedia: Acute cholecystitis link
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.