Chintapalli K N, Ghiatas A A, Chopra S, Escobar B, Esola C C, Dodd G D
Department of Radiology, The University of Texas Health Science Center at San Antonio, 78284-7800, USA.
J Clin Ultrasound. 1999 Mar-Apr;27(3):117-21. doi: 10.1002/(sici)1097-0096(199903/04)27:3<117::aid-jcu3>3.0.co;2-u.
PURPOSE. We retrospectively evaluated sonographic findings in 946 cases of gallstones to determine whether the false-negative rate for gallstone detection by sonography has decreased as a result of technologic advances over the past 15 years.
We reviewed preoperative sonographic reports, operative notes, and pathologic reports for 614 women and 332 men (ages 22-78 years) seen over a 2.5-year period and compared sonographic findings with surgical pathologic findings after cholecystectomy. Sonograms for patients whose gallstones were missed on sonography were reviewed by 3 board-certified radiologists.
Preoperative sonography of the gallbladder accurately predicted the presence of gallstones in 934 cases (98.7%). Gallstones were not identified by sonography in the remaining 12 cases. In those cases, sonography revealed polyps in 5, sludge in 5, sludge plus a polyp in 1, and neither stones nor polyps in 1. Thus, the false-negative rate was 1.3%.
Despite improvements in sonographic technology, detection of small gallstones remains difficult in some cases. Adherent gallstones can mimic gallbladder polyps. Our false-negative rate for detection of gallstones was no different from that in earlier studies.
目的。我们回顾性评估了946例胆结石患者的超声检查结果，以确定过去15年技术进步是否使超声检测胆结石的假阴性率有所降低。
我们回顾了2.5年期间614名女性和332名男性（年龄22 - 78岁）的术前超声报告、手术记录和病理报告，并将超声检查结果与胆囊切除术后的手术病理结果进行比较。对超声检查漏诊胆结石的患者的超声图像由3名经过委员会认证的放射科医生进行复查。
术前胆囊超声检查在934例（98.7%）中准确预测了胆结石的存在。其余12例超声检查未发现胆结石。在这些病例中，超声检查发现5例有息肉，5例有胆泥，1例有胆泥加息肉，1例既无结石也无息肉。因此，假阴性率为1.3%。
尽管超声技术有所改进，但在某些情况下，小胆结石的检测仍然困难。附着的胆结石可能会被误诊为胆囊息肉。我们检测胆结石的假阴性率与早期研究无差异。
