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Intact stones or fragments? Potential pitfalls in the imaging of patients after biliary extracorporeal shock wave lithotripsy

Khouri, Margaret R; Goldszmidt, Jeannete B; Laufer, Igor; Arger, Peter; Marcus, Adrian; Wisniewski, Frances; Ekberg, Olle LU and Malet, Peter F (1990) In Radiology 177(1). p.147-151
Abstract
Ultrasound is used after extracorporeal shock wave lithotripsy of gallbladder stones to assess fragmentation. In many patients with apparently successful fragmentation, the posttreatment studies show an intraluminal, echogenic focus within the gallbladder, with posterior acoustic shadowing characteristic of an intact stone. Cholesterol gallstones were fragmented in vitro by means of lithotripsy, and the sonographic appearance of the fragmented stones was followed up over time to study factors that might affect the process. After lithotripsy, fragments settled and produced an echogenic focus with posterior shadowing indistinguishable from the appearance of an intact stone. These experimental observations led to the development of a clinical... (More)
Ultrasound is used after extracorporeal shock wave lithotripsy of gallbladder stones to assess fragmentation. In many patients with apparently successful fragmentation, the posttreatment studies show an intraluminal, echogenic focus within the gallbladder, with posterior acoustic shadowing characteristic of an intact stone. Cholesterol gallstones were fragmented in vitro by means of lithotripsy, and the sonographic appearance of the fragmented stones was followed up over time to study factors that might affect the process. After lithotripsy, fragments settled and produced an echogenic focus with posterior shadowing indistinguishable from the appearance of an intact stone. These experimental observations led to the development of a clinical maneuver to overcome the diagnostic pitfalls posed by the reaggregation of stone fragments in situ. This rollover maneuver helps distinguish between intact stones and fragments, and prevents both diagnostic errors in follow-up and unnecessary retreatment. (Less)
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author
publishing date
type
Contribution to journal
publication status
published
subject
in
Radiology
volume
177
issue
1
pages
147 - 151
publisher
Radiological Society of North America
external identifiers
  • pmid:2204959
  • scopus:0025158506
ISSN
1527-1315
language
English
LU publication?
no
id
d27178bd-c267-49cb-8070-5d2ccce2655e (old id 1105134)
alternative location
http://radiology.rsnajnls.org/cgi/reprint/177/1/147
date added to LUP
2008-08-05 09:43:17
date last changed
2017-01-01 06:43:20
@article{d27178bd-c267-49cb-8070-5d2ccce2655e,
  abstract     = {Ultrasound is used after extracorporeal shock wave lithotripsy of gallbladder stones to assess fragmentation. In many patients with apparently successful fragmentation, the posttreatment studies show an intraluminal, echogenic focus within the gallbladder, with posterior acoustic shadowing characteristic of an intact stone. Cholesterol gallstones were fragmented in vitro by means of lithotripsy, and the sonographic appearance of the fragmented stones was followed up over time to study factors that might affect the process. After lithotripsy, fragments settled and produced an echogenic focus with posterior shadowing indistinguishable from the appearance of an intact stone. These experimental observations led to the development of a clinical maneuver to overcome the diagnostic pitfalls posed by the reaggregation of stone fragments in situ. This rollover maneuver helps distinguish between intact stones and fragments, and prevents both diagnostic errors in follow-up and unnecessary retreatment.},
  author       = {Khouri, Margaret R and Goldszmidt, Jeannete B and Laufer, Igor and Arger, Peter and Marcus, Adrian and Wisniewski, Frances and Ekberg, Olle and Malet, Peter F},
  issn         = {1527-1315},
  language     = {eng},
  number       = {1},
  pages        = {147--151},
  publisher    = {Radiological Society of North America},
  series       = {Radiology},
  title        = {Intact stones or fragments? Potential pitfalls in the imaging of patients after biliary extracorporeal shock wave lithotripsy},
  volume       = {177},
  year         = {1990},
}