Standards of the Polish Ultrasound Society – update. The liver, gallbladder and bile ducts examinations

Ultrasonography, which usually constitutes an initial imaging method of the gallbladder, liver and bile ducts diseases, allows for final diagnosis or determines another diagnostic step. The continuously progressing technological advancement forces to broaden the indications for ultrasound diagnostics and enables easier and more precise imaging of the tested structures. Performing the examination in accordance with current standards allows for the optimization of the sensitivity and specificity parameters of ultrasound examinations in the diagnosis of the liver, gallbladder and bile ducts pathologies as well as minimizes the probability of error-making. This article presents a recommended liver, gallbladder and bile ducts ultrasound technique which indicates an optimal positioning of the patient for the exam as well as the sites of the ultrasound transducer application. Minimum technical parameters of the apparatus have been specified with respect to the requirements of modern ultrasound techniques which enable imaging with the use of contrast agents and elastography. Furthermore, the article proposes a standard exam description containing essential patient-related data and provides required ultrasound evaluation parameters for the tested organs. Attention has been drawn to the appropriate manner of preparing the patient for the examination and the features of the tested structures have been presented. The article also contains a brief description of the liver, gallbladder and bile ducts diseases which are most often diagnosed by ultrasound examinations. Moreover, the use of elastography as well as contrast-enhanced examinations in the diagnostics of fibrosis and focal changes in the liver have been discussed. This article has been prepared on the basis of the Ultrasound Examination Standards of the Polish Ultrasound Society (2011) and updated with reference to the latest findings in pertinent literature.