New Trends in Gallbladder Imaging

GALLBLADDER disease accounts for more than 500,000 operations annually in the United States and is the most common indication for abdominal surgery and the fourth most common cause of surgical hospitalization in adults.¹ For almost 60 years, since the introduction by Graham and Cole₂of the oral cholecystogram (OCG) in 1924, it has remained the unchallenged method for investigation of gallbladder disease. Nevertheless, despite its accuracy, safety, and ease of performance, the future of the oral cholecystogram is presently in doubt, principally as a result of the recent advent of gray-scale ultrasound. Ultrasonic techniques, including realtime scanning, have demonstrated remarkable sensitivity and specificity for nearly the entire spectrum of gallbladder disease. In some centers, ultrasonography is now employed as the primary screening technique for detection of gallbladder pathology. Because cholecystosonography may lead to revisions in clinical approaches to diagnosis of gallbladder disease, this review of principles, results, and