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By Bates J.

A complete advisor to belly ultrasound, together with easy anatomy, procedure and ultrasound appearances including the most typical pathological tactics. might be hugely illustrated with top of the range scans, many in color.

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Extra resources for Abdominal Ultrasound: How, Why and When

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29). Measure the wall thickness in a longitudinal section of the gallbladder, with the calipers perpendicular to the wall itself. ) After fasting for around six hours, it should be distended with bile into an elongated pear-shaped sac. The size is too variable to allow direct measurements to be of any use, but a tense, rounded shape can indicate pathological, rather than physiological dilatation. Because the size, shape and position of the gallbladder are infinitely variable, so are the techniques required to scan it.

Also contained in the portal tracts are a branch of the hepatic artery and a biliary duct radical. These latter vessels are too small to detect by ultrasound in the peripheral parts of the liver, but can readily be demonstrated in the larger, proximal branches (Fig. 19). At the porta, the hepatic artery generally crosses the anterior aspect of the portal vein, with the common duct anterior to this (Fig. 20). In a common variation the artery lies anterior to the duct. Peripherally, the relationship between the vessels in the portal tracts is variable, (Fig.

Spectra is an integral part of the upper-abdominal ultrasound scan. Doppler of the portal venous and hepatic vascular systems gives information on the patency, velocity and direction of flow. The appearance of the various spectral waveforms relates to the downstream resistance of the vascular bed (see Chapter 1). 25). The hepatic veins drain the liver into the IVC, which leads into the right atrium. Two factors shape the hepatic venous spectrum: the flexible nature of the normal liver, which can easily expand to accommodate blood flow, and the close proximity of the right atrium, which causes a brief ‘kick’ of blood back into the liver during atrial systole (Fig.

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