Value of prone positioning in the ultrasonographic diagnosis of gallstones: prospective study.

Hough, David M.; Glazebrook, Katie; Paulson, Erik K.; Bowie, J D; Foster, William L.

doi:10.7863/jum.2000.19.9.633

Cited by 10 publications

(5 citation statements)

References 10 publications

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“…The main purpose of this paper is to demonstrate whether supplementary anatomical and/or pathological detail may be available using a previously unreported technique. 5 Although the mean additional length of gallbladder demonstrated using the reverse decubitus position in this series of patients was small at 0.9 cm (in some cases very small at 0.1 cm), in all subjects in this study some additional anatomical detail was demonstrated; in some subjects a significant additional gallbladder length of up to 2 cm was demonstrated. It is possible that these appearances are partially attributable to geometric variations, but this influence does not seem likely as many of the LAO scans were performed using a right-sided approach.…”

Section: Resultsmentioning

confidence: 45%

The 'Reverse Decubitus' View: a Potential for Increasing the Sensitivity of Gallbladder Ultrasound

Kletzenbauer¹

2004

Ultrasound

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The purpose is to determine whether a variation of the standard decubitus patient positioning is of additional diagnostic value. Traditionally, the gallbladder is examined with the patient in the supine, right side up decubitus, erect and prone positions. However, with the patient in the left side up position a medial/cranial/oblique angulation of the transducer allows an additional acoustic window to the gallbladder fossa. As well as potentially demonstrating exquisite views of the gall bladder, it is asserted that previously unseen pathology may occasionally be detected. Thirty patients were examined using the routine patient positions and, in addition, the gallbladder was examined with each patient in the left side up position. In all cases, a longer axis was measurable with the patient left side up. In one case, pathology that was not appreciated in the routine patient positions was seen with the patient left side up. This study suggests that additional anatomical and pathological may be demonstrated by using the technique described.

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Section: Resultsmentioning

confidence: 45%

The 'Reverse Decubitus' View: a Potential for Increasing the Sensitivity of Gallbladder Ultrasound

Kletzenbauer¹

2004

Ultrasound

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“…When performing local ablation therapies, it is important to obtain a better sonographic window and plan a safe puncture route. Various body positions have been attempted for better visualization of the entire liver during US examinations [ 31 , 38 , 39 ]. Among various body positions, supine, right half side lying, left half side lying, head up, and upright were mainly used according to the site of the tumor and the patient’s body size empirically.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Body Position Change during Local Ablation Therapies for the High-Risk Location Hepatocellular Carcinoma

Takada,

Komiyama,

Osawa

et al. 2024

Cancers

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Local ablation therapies are important treatment options for early-stage hepatocellular carcinoma (HCC). Various techniques have been used to perform these therapies efficiently and safely. However, few reports have discussed the usefulness of body position change (BPC). This study aimed to investigate the usefulness of BPC during local ablation therapies in patients with HCC. We evaluated 283 HCC nodules that underwent local ablation therapy. These nodules were categorized into high- or low-risk locations on the basis of their proximity to large vessels, adjacent extrahepatic organs, or poor visibility under ultrasound (US) guidance. The technical success rates, procedure time, and prognosis were evaluated. In this study, 176 (62%) nodules were classified in the high-risk location group. The high-risk location group was treated with techniques such as BPC, artificial pleural fluid, artificial ascites, fusion imaging, and contrast-enhanced US more frequently than the low-risk location group. The technical success rates were 96% and 95% for the high- and low-risk location groups, respectively. Within the high-risk location group, those without BPC had a lower success rate than those with BPC (91% vs. 99%, p = 0.015). Notably, BPC emerged as the sole contributing factor to the technical success rate in the high-risk location group (OR = 10, 95% CI 1.2–86, p = 0.034). In contrast, no differences were found in the procedure time, local tumor progression rates, intrahepatic distant recurrence rates, and overall survival between the groups with and without BPC in the high-risk location group. In conclusion, BPC during local ablation therapy in patients with HCC in high-risk locations was safe and efficient. The body position should be adjusted for HCC in high-risk locations to maintain good US visibility and ensure a safe puncture route in patients undergoing local ablation therapies.

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“…The value of using upright and prone positioning to detect gallstones and show mobility has been recognized by experienced radiologists and sonographers for many years. 4,8 The 2017 American College of Radiology Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum specifies that the gallbladder should be viewed in the supine position and when feasible in the decubitus position (RLD or LLD not specified). It also states that "Other positions such as erect or prone imaging may be helpful to evaluate the gallbladder and its surrounding areas completely."…”

Section: Discussionmentioning

confidence: 99%

Optimization of Patient Positioning for the Sonographic Evaluation of Gallstone Impaction: Analysis of Gallbladder Orientation Based on Computed Tomography

Zulfiqar¹,

Calhoun²,

Shetty³

et al. 2022

Ultrasound Quarterly

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An important sonographic sign of cholecystitis is stone impaction in the gallbladder neck. Demonstration of stone mobility excludes impaction. The purpose of this study is to analyze the orientation of the gallbladder on computed tomography and determine the patient position most likely to facilitate stone mobility. ImageJ processing software was used to determine the x (transverse), y (anterior-posterior), and z (craniocaudal) coordinates for the gallbladder neck and fundus in 544 consecutive computed tomography examinations. The differences in the fundal and neck coordinates were used to determine the likelihood of moving a stone from the neck to the fundus for the left and right lateral decubitus positions (x coordinates), the prone position (y coordinates), and the upright position (z coordinates). The coordinate with the largest difference was considered to predict the position most likely to facilitate stone motion. The difference in position of the fundus and neck was greatest in the y-, z-, and x-axis in 232 (42.6%), 194 (35.7%), and 118 (21.7%) of patients, respectively. For body mass index (BMI) less than 25 kg/m 2 , the difference was greatest in the z-axis (59.8%). For BMI greater than 25 kg/m 2 , the difference was greatest in the y-axis (47.1%). Based on their relative location, the optimal position to facilitate gallstone mobility from the gallbladder neck to fundus was most often prone (especially in high BMI patients), followed by upright (especially in low BMI patients), followed by right lateral decubitus. The left lateral decubitus position was never optimal.

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Value of prone positioning in the ultrasonographic diagnosis of gallstones: prospective study.

Cited by 10 publications

References 10 publications

The 'Reverse Decubitus' View: a Potential for Increasing the Sensitivity of Gallbladder Ultrasound

The 'Reverse Decubitus' View: a Potential for Increasing the Sensitivity of Gallbladder Ultrasound

Usefulness of Body Position Change during Local Ablation Therapies for the High-Risk Location Hepatocellular Carcinoma

Optimization of Patient Positioning for the Sonographic Evaluation of Gallstone Impaction: Analysis of Gallbladder Orientation Based on Computed Tomography

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