Comparison of real-time and static-mode gray-scale ultrasonography in the diagnosis of cholelithiasis.

Real-time and conventional articulated-arm gray-scale static-mode scanning were performed on 100 patients in a prospective study to determine the complementary or duplicative roles of these two ultrasound modalities in the confirmation of clinically suspected cholelithiasis. Twenty-five abnormal findings were documented ultrasonographically, including 21 cases of cholelithiasis (12 confirmed by oral cholecystography and/or surgery), two cases of biliary sludge, one case of a gallbladder polyp, and one case of a probable blood clot. There was no instance of gallbladder lumen nonvisualization. Except in one case (that of a 420-pound patient), real-time ultrasonography documented all the gallbladder abnormalities shown by the articulated-arm static scans. In two cases, one corroborated by oral cholecystography, cholelithiasis was documented by real-time and not by static-mode ultrasonography. In most cases, real-time ultrasonography can be used to document the presence of cholelithiasis and obviate the need for conventional articulated-arm static-mode scanning.