Ultrasound studies of the gallbladder can be successfully performed the same day as intravenous urography or contrast-enhanced CT exams, according to research published in the Journal of Ultrasound in Medicine.
It's important to wait two hours after contrast administration, however, to allow for gallbladder volume to be restored to pre-contrast values, according to researchers from the University of the West Indies in St. Augustine, Trinidad. The study was conducted prospectively on 153 patients referred for excretory urography or abdominal CT (JUM, August 2002, Vol.21:9, pp. 977-981).
The patient cohort was split into two groups. Sixty-six patients received IV contrast agents, and 87 were given oral contrast media. Of the IV group, 38 patients received a low-osmolar contrast agent, while 28 got a standard ionic agent. In the second group receiving oral contrast media, 48 received a low-osmolar agent, and 39 used the standard ionic agent.
The same sonographer, blinded to whether the patient had received oral or IV contrast, performed ultrasound studies on all of the patients before contrast administration, and at half-hour intervals up to two hours afterwards. Change in gallbladder volume was judged in terms of percentages before and after contrast administration at various intervals.
In the IV group, nonionic contrast patients had a mean gallbladder volume of 70.1% at 30 minutes, 77.9% at 60 minutes, 87.8% at 90 minutes, and 100.5% at two hours. Subjects receiving ionic agents had a mean gallbladder volume of 72.1% at 30 minutes, 79.4% at 60 minutes, 87.5% at 90 minutes, and 100.5% at two hours.
In the oral group, nonionic contrast patients had a mean gallbladder volume of 70.7%, 77.4%, 84.9%, and 98.1% at 30 minutes, 60 minutes, 90 minutes, and two hours, respectively. In the same time periods, patients with administered ionic media had mean volumes of 68.1%, 78.3%, 84.5%, and 99.4%.
"The sequential volume change as a function of time reveals that renormalization of gallbladder only occurs two hours after contrast agent administration and is independent of the route of administration or contrast agent osmolarity," the authors wrote. "Thus any strategy involving same-day sonographic or CT assessment of the gallbladder after iodinated contrast-enhanced studies should ideally wait until this period has elapsed."
As an alternative, the researchers suggested that ultrasound be considered as the initial imaging modality for the gallbladder whenever iodinated contrast-enhanced investigations are anticipated.
By Erik L. RidleyAuntMinnie.com staff writer
September 20, 2002
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Copyright © 2002 AuntMinnie.com
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![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
