The best test to evaluate the gallbladder is usually an ultrasound. While many other imaging tests are able to identify abnormalities, ultrasound is the best test to evaluate for gallstones, inflamed gallbladder and gallbladder cancer. Ultrasound also uses no radiation and is relatively fast and inexpensive. An ultrasound is performed by a specially trained technician and read by a radiologist.
Ultrasound of the gallbladder is often ordered for symptoms that are believed to originate from the gallbladder and right upper abdomen. Gallstones can cause biliary colic. This is pain from blockage of the bile duct by a stone which passes. Ultrasound is also the best test to detect stones. Ultrasound can detect all types of stones including ones which are not calcified.
Cholecystitis or inflamed gallbladder can also be caused by gallstones. When we have an inflamed gallbladder, we often see a big distended gallbladder. The wall is thickened and there can be fluid around it. Often there is pain when the technologist applies pressure over the gallbladder.
Gallbladder polyps are also best detected with ultrasound. Most of these growths along the wall are benign but some can be cancerous. Gallbladder cancer is also best detected with ultrasound. Ultrasound will often show a mass with irregular margins. There may be invasion of the liver. The prognosis is usually poor.
Gallbladder disease can also be identified with CT or MRI. CT and MRI sometimes shows inflammation around the gallbladder when a patient has cholecystitis. Nuclear medicine HIDA scans are good at confirming cholecystitis when the diagnosis is in question. This involves injecting a tiny amount of radioactive material and imaging the gallbladder. Masses can also be seen at times on CT or MRI.
The best test to image the gallbladder is usually ultrasound. However, other imaging tests play a role as well for more specific questions. Sometimes abnormalities of the gallbladder are first detected on tests other than ultrasound. Ultrasound of the gallbladder also examines the organs in the right upper quadrant like the liver, kidney, and pancreas. This can identify abnormalities outside the gallbladder responsible for symptoms.