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III ()
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100
100
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1, 2000

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RI 0,66
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100
86

91
97


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94



.



.
I : .



: 
, 

,
, 
, 

.


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, 
.
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.

1. .., .., .. 

// . 1989. 7. . 38.
2. .. . , 1989.
3. .., .., , 
..
// 
. 1995. 6. . 1922.
4. Ralls P.W., Colletti P.M., Lapin S.A. Realtime
sonography in suspected acute cholecystitis //
Radiology. 1985. V. 155. P. 767771.
5. Jeffrey R.B., Sommer F.G. Followup sonography in
suspected acalculous cholecystitis: preliminary clini
cal experience // J. Ultrasound Med. 1993. V. 4.
P. 183186.
6. Laing F.C., Federle M.P., Jeffrey R.B. Ultrasonic
evaluation of patients with acute right upper quad
rant pain // ARJ. 1981. V. 140. P. 449455.
7. Shuman W.P., Mack L.A., Rudd T.G. Evaluation of
acute right upper quadrant pain: sonography and
99mmTcPIPIDA cholescintigraphy // ARJ. 1982.
V. 139. P. 6163.
8. Shuman W.P., Rogers J.V., Rudd T.G. Low sensitiv
ity of sonography and cholescintigraphy in acalcu
lous cholecystitis // ARJ. 1984. V. 142. P. 531534.
9. Simeone J.F., Brink J.A., Mueller P.R. The sono
graphic diagnosis of acute gangrenous cholecystitis:
importance of the Murphy sign // ARJ. 1989. V. 152.
P. 289292.
10. ..
// 
, 
. 1994. 2. C. 101126.
11. .., .., .., 
.. 
//
. 1988. 9. C. 2733.
12. Derchi L.E., Martinoli C., Silvestri E. Abdominal
Doppler echography. Pathologic arterial signals //
Radiol. Med. Torino. 1993. V. 85. P. 161169.
13. Gow B.S. Circulation correlates: vascular impedance,
resistance and capacity // Handbook of physiology /
Ed. by Bohr D.F. V. II. Baltimore: Williams &
Wilkins, 1980. P. 353.

13


14. Guyton A.C. Textbook of medical physiology.
Philadelphia: W.B. Saunders Co., 1991.
15. Jeffrey R.B., NinoMurcia M., Ralls P.W. et al. Color
Doppler sonography of the cystic artery: comparison
of normal controls and patients with acute cholecysti
tis // J. Ultrasound Med. 1995. V. 14. P. 3336.
16. Cann R.P. Gallbladder and biliary tree // Diagnostic
Medical Sonography / Ed. by Kawamura D.M. V. 3.
Abdomen. Philadelphia: J.B. Lippincott Co., 1992.
P. 151198.
17. Cooperberg B.B. Gallbladder and bile ducts //
Abdominal Ultrasonography / Ed. by Goldberg B.B.
N.Y.: J. Wiley & Sons, 1984.
18. Middleton W.D. Gallbladder // Textbook of Abdomi
nal Ultrasound / Ed. by Goldberg B.B. Baltimore:
Williams & Wilkins, 1993. P. 116146.
19. Taylor K.J.W. The gallbladder and biliary tree //
Atlas of Ultrasonography / Ed. by Taylor K.J.W.
V. 1. N.Y.: Churchill Livingstone, 1985. P. 541623.
20. Weill F.S. Biliary tract // Ultrasonography of
Digestive Diseases / Ed. by Weill F.S. St. Louis:
C.V. Mosby Co., 1982. P. 217275.

1, 2000
21. Dickson P.R., Smouse H.R., Pham M.T. et al. Color
Doppler US of thickened gallbladder wall //
Radiology. 1993. V. 189. P. 426.
22. Furuta T., Nakazawa S., Yamao K. et al. Usefulness
of color Doppler flow imaging for the gallbladder
lesions with thickened wall // Jpn. J. Med.
Ultrasonics. 1993. V. 20. P. 427428.
23. Ueki T., Sakagushi S., Hatono N. et al. Evaluation of
ultrasonic color Doppler flow mapping in gallbladder
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P. 429430.
24. Harshfield D., Porter M., Teplick S. Pathologic corre
lation of color flow Doppler and acute cholecystitis //
AJR. 1993. V. 160. P. 64.
25. Yamashita Y., Lim I., Ogasawara T. et al. Evaluation
of the color Doppler imaging in the cases of acute
cholecystitis // Jpn. J. Med. Ultrasonics. 1993.
V. 20. P. 431432.
26. Paulson E.K., Kliewer M.A., Hertzberg B.S.
Diagnosis of acute cholecystitis with color Doppler
sonography: significance of arterial flow in thickened
gallbladder wall // AJR. 1994. V. 162. P. 11051108.

Role of Doppler Techniques

in the Diagnosis of Gallbladder
Inflammatory Diseases
V.V. Mitkov, M.D. Mitkova, and R.B. Mumladze
100 patients with various diseases of gall bladder and 60 patients without gallbladder pathol"
ogy were investigated. The first (control) group includes 60 patients with absence of gallbladder
diseases. The second group includes 50 patients with chronic calculous cholecystitis. Third group
includes 32 patients with acute calculous cholecystitis. The fourth group includes 18 patients with
benignpolyps and adenomas (12) and malignant (6) gallbladder diseases. Besides the standard
parameters of gray scale echography segmental gallbladder wall blood flow was assessed and RI
and PI were estimated. The patients with chronic calculous cholecystitis, with polyps and adeno"
mas of gall bladder, and also patients of control group had practically identical Doppler blood flow
pattern (color flow mapping and power Doppler). Blood flow signals were visualized either in I, or
in II segments, or were not determined in the gallbladder wall. On the other hand, Doppler pattern
in patients with acute calculous cholecystitis considerably differed and was characterized by
occurrence of blood flow signals in III and IV segments of a gall bladder. PW Doppler has revealed
the tendency to decrease RI and PI in acute calculous cholecystitis.

14