Holografia

Poligrafia is the method of roentgenologic examination of the gallbladder and bile ducts through intravenous administration of contrast agents , followed by x-rays. On hologrammes identify organic and functional lesions of the gallbladder and bile ducts. Indications for holegrafii, determined by the physician. Cm. also Cholangiography, Cholecystography.

Holografia (from the Greek. chole - bile and grapho - writing, picture) is the method of roentgenologic examination of the bile ducts and gall bladder. The method is based on the physiological ability of the liver to catch from the blood of organic iodine compounds and to allocate them together with bile.
For holegrafii used contrast agents (see), an organic iodine compounds (bilignost, bilivistan etc). These contrast medium is injected surveyed intravenous (bilignost dose of 30-40 ml of 20% solution).
In the normal state of the liver in 5-10 minutes after injection of a contrast agent on the x-ray image appears larger intra - and extrahepatic bile ducts. If cystic duct go, soon the shots looming shadow of the gallbladder. At vertical position of the subject contrast bile originally defined only in the neck of the bladder and distinguished from the former in a bubble with no bile clear level (phase Dyloject bile). Gradually the number of contrast of the bile bladder increases and low-contrast decreases. In 40-45 minutes after injection in a bubble are found narrow wall strips contrast bile (Fig. 1), and layer contrast bile at the bottom (phase three-layer bile). Within 2 to 4 hours after administration of bilignost shadow bladder becomes almost homogeneous. The presence of parietal contrasting stripes and phase three-layer bile suggests maintaining a bubble concentration ability. If holegrafii, unlike x-ray study (see), the shadow of the bubble can be obtained at the loss of the concentration function, but the layering of bile in such cases is absent.
By using holegrafii you can explore the position, size and shape of the gallbladder, discover distortion or restriction of smaduamei in the presence of adhesions.
The analysis of the course of filling bladder allows to judge about its concentration, and the analysis of the discharge of his motor abilities. If the bladder are the stones, they contribute to the heterogeneity of its shadow, the appearance of it filling defects (Fig. 2). No shadow of a gall bladder in the presence of the image of the bile duct is a sign of obstruction of the cystic duct.
The main advantage of holegrafii is the ability to judge the situation, the caliber and road intra - and extrahepatic bile ducts. In violation of the functions of the sphincter of Oddi, and in the presence of duct stones observed its expansion.
The stone itself causes a filling defect in the shadow of the duct (Fig. 3).
Holografia shown if necessary, x-ray studies of the bile ducts (including in patients underwent cholecystectomy)and in all patients with x-ray study is not received a shadow of the gallbladder. Contraindications are heavy defeat of the liver, kidneys and cardiovascular system, intolerance of iodine. In order to prevent the possible side effects (dizziness, nausea, vomiting, and others, in rare cases, collapse) recommended antihistamines (depression).
Cm. also Cholangiography.

Fig. 1. Hologramme in the normal state of the biliary tract. Visible liver, common bile ducts and gallbladder. In the gallbladder - layered content: two layers of contrasting bile and between the layer of low-contrast bile.
Fig. 2. Deformed gallbladder (hourglass-shaped) with many stones.
Fig. 3. Hologramme in a patient who underwent cholecystectomy. The common bile duct moderately expanded its terminal division - filling defect caused by a single stone (arrow).