實時間超音波對肝外膽道擴張及膽道結石之偵測－初報

Detection of Extrahepatic Biliary Dilatation and Lithiasis by Real-Time Ultrasonography-A Preliminary Report

鄭復隆(Fu-Lung Cheng) ； 周宜宏(Yi-Hong Chou) ； 許重權(Chung-Chern Hsu) ； 刁翠美(Chui-Mei Tiu) ； 姜仁惠(Jen-Huey Chiang) ； 吳峻吉(Chun-Chi Wu) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 11卷1期 (1986/03) Pp. 49-56

摘要

自民國74年1月至4月之4個月內，以實時間超音波(RTUS)檢查了350例病人，其中32例在檢查後之數小時至10日之間因各種原因接受腫囊或胆道手術；RTUS以4mm為總肝管內徑之上限及7mm為總胆管內徑之上限為評估標準，其所得診斷阻塞之敏感性為87.5%、特異性為86.7%、準確度為87.1%。如果分別以6mm及10mm為上限時，則各為75.0%、93.3%、83.9%，而對結石之偵測各為55%、95%、81%；如將肝外胆道分為5部分，其呈示率各為100%、100%、74.2%、38.7%、48.4%，末二段的呈示率不高是造成偵測結石失敗的主因，組道未擴張或結石太小亦影響偵測；實驗室數據與腫道擴張之關係並不密切，但可作為一輪助診斷的工具；RTUS實為一便捷且非侵犯性的診斷工具。

並列摘要

Within the first four months of 1985, 350 patients have been referred for real-time biliary ultrasonography (RTUS). Thirty-one patients received biliary surgery within either a few hours or ten days after examination. When the upper limit of the inner diameters of the common hepatic duct and common bile duct were assigned as 4mm and 7mm, the sensitivity for diagnosing obstruction was 87.5%; specificity, 86.7% and accuracy, 87.1%. If the upper limits were assigned as 6mm and 10mm respectively, the above data would be changed into 75%, 93.5% and 83.9%. The sensitivity, specificity and accuracy for detection of lithiasis were 55%, 95% and 81%. If the extrahepatic biliary system was divided into five parts, their visibility would be 100%, 100%, 74.2%, 38.7% and 48.4% respectively. The low percentage of the visibility of the last two parts of the extra biliary system is a major hindrance for detection of biliary lithiasis. On the other hand, absence of the biliary ectasia or small-sized stones also hindred thedetection. The laboratory data were not closely related to biliary ectasia but could be used as a supplimentary information. Biliary lithiasis could induce complications and raised the mortality and susceptibility of patients with cholelithiasis. Therefore, a convenient and non-invasive diagnostic modality is quite impotant for this type of patients. It is necessay to increase the detectability of the 4th and 5th portions of the extrahepatic bile duct by technical improvement in order to increase the corresponding sensitivity.