Читать книгу Point-of-Care Ultrasound Techniques for the Small Animal Practitioner - Группа авторов - Страница 153

These artifacts result in loss of interpretive clarity by the ultrasound machine along any luminal borders, in this case the gallbladder, thus, falsely making the gallbladder appear to contain sediment, other intraluminal abnormalities, or a mass, as well as defects along its wall similar to the urinary bladder (see Figure 6.26) (see Chapters 3 and 5).

Figure 6.15. Pitfalls at the DH view related to the gallbladder, hepatic venous system, and stomach wall. In (A) the gallbladder (GB) appears triangulated, mimicking free fluid, but by fanning through the gallbladder in both directions, this mistake is less likely to occur. Moreover, free fluid does not have hyperechoic borders as the wall of the gallbladder does. In (B) branching of the hepatic venous system mimics free fluid. In real time and through repetition, the sonographer will get used to where fluid typically pools as well as incorporating the added information of performing the entire AFAST. In (C) the stomach is fluid filled in this patient and can mimic the gallbladder to the hasty sonographer; and its sonographically layered wall can mimic gallbladder wall edema. This area should be avoided by rocking the probe more cranial as shown in the many DH views within this chapter and Figure 5.10. GB, gallbladder; LIV, liver; ST, stomach.

Source: Reproduced with permission of Dr Gregory Lisciandro, Hill Country Veterinary Specialists and FASTVet.com, Spicewood, TX.