Ultrasound in the examination of the gallbladder - a holistic approach: grey scale, Doppler, CEUS, elastography, and 3D

Ultrasonography (US) is the essential imaging method in gallbladder examination being the most widespread and inexpensive technique. The method is indicated both in congenital and acquired disorders, inflammatory, tumoral, or degenerative pathology. Besides the basic technique (grey scale US), new sophisticated techniques exist: Doppler US, i.v. contrast enhanced harmonic examination, tridimensional US, elastography. Each technique provides specific information, while their combination helps, in most cases, to establish the accurate non-invasive diagnosis. However, the US findings should be correlated with the patient's clinical exam and other imaging methods. This paper is a synthesis of literature combined with our own experience, aiming to present the US features of gallbladder pathology and the correlations within the clinical picture and other imaging methods. Relevant images for this integrative approach are presented. The final conclusion is the necessity for a correlation of all clinical and imaging data in order to obtain an accurate diagnosis.