ROSH Gastrointestinal Practice Exam

Which imaging study is typically used to assess for gallstones in symptomatic patients?

1. CT scan of the abdomen

2. Abdominal ultrasound

3. MRI of the abdomen

4. X-ray of the abdomen

The correct answer is: Abdominal ultrasound

The abdominal ultrasound is the imaging study of choice for assessing gallstones in symptomatic patients due to its effectiveness and non-invasive nature. Ultrasound uses sound waves to create images of the internal organs and is especially proficient at visualizing gallstones because these stones are usually echogenic (bright on ultrasound) and can be readily identified within the gallbladder. In addition, ultrasound does not involve ionizing radiation, making it a safer option, especially for certain populations such as pregnant women. It can also help assess the presence of complications associated with gallstones, such as gallbladder inflammation (cholecystitis) or bile duct obstruction, further enhancing its utility in evaluating symptomatic patients. While other imaging modalities like CT scans can also detect gallstones, they are not the first-line choice due to higher radiation exposure and generally greater cost. MRI could be utilized for specific cases, especially when looking for potential complications or anatomical anomalies but is not routinely used for gallstone detection. X-rays are limited in detecting gallstones as most are not calcified and might not be visible, thus making it less useful for this diagnosis.