Background: Ultrasound of the gallbladder is an excellent imaging modality in the assessment of gallbladder disease. Contrast-enhanced ultrasound (CEUS) is well established in the diagnosis of focal liver lesions, but its application is not as well recognised in gallbladder and biliary disease.

Summary: This presentation will discuss our experience at Royal Melbourne Hospital of contrast-enhanced ultrasound in the evaluation of patients with biliary disease. The contrast ultrasound appearances of a range of GB diseases will be presented , including sludge, cholecystitis and its complications of ulceration and perforation, adenomyomatosis, polyps and carcinoma. The indications, advantages and limitations of CEUS in the evaluation of gallbladder pathology will be covered.

Discusssions and Conclusions: CEUS of the biliary system is an evolving tool, and although it is less established, it can be useful in the evaluation of GB biliary disease when used as an adjuct to B-mode ultrasound. Ongoing research and use will serve to better define the role of CEUS in biliary disease.