Farrant P, Meire H B, Mieli-Vergani G
Variety Club Children's Hospital, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
Br J Radiol. 2000 Nov;73(875):1154-8. doi: 10.1259/bjr.73.875.11144791.
An initial investigation of 313 patients suggested that the ultrasound appearances of gall bladder shape and wall structure might be abnormal in infants with biliary atresia. These observations were then tested in a prospective study. In this study, 346 infants, aged 12 weeks or less, presenting with conjugated hyperbilirubinaemia underwent ultrasound scanning. The gall bladder was identified in 331, 60 of whom had biliary atresia. 11 of the 15 patients in whom the gall bladder was not seen had biliary atresia. Gall bladder shape was normal in 272 patients, 16 of whom had biliary atresia, and irregular in 59, 44 of whom had biliary atresia. The gall bladder wall was regular in 262 patients, 8 of whom had biliary atresia, and irregular in 69, 52 of whom had biliary atresia. Combining these findings gave a sensitivity of 90%, a specificity of 92.4%, a positive predictive value of 75.3%, a negative predictive value of 97.3% and an accuracy rate of 91.9% for ultrasound of the gall bladder in identification of biliary atresia.
对313例患者的初步调查表明，胆道闭锁婴儿的胆囊形状和壁结构的超声表现可能异常。然后在一项前瞻性研究中对这些观察结果进行了验证。在这项研究中，对346例年龄在12周及以下、伴有结合胆红素血症的婴儿进行了超声扫描。331例婴儿的胆囊可被识别，其中60例患有胆道闭锁。在胆囊未被观察到的15例患者中，有11例患有胆道闭锁。272例患者的胆囊形状正常，其中16例患有胆道闭锁；59例患者的胆囊形状不规则，其中44例患有胆道闭锁。262例患者的胆囊壁规则，其中8例患有胆道闭锁；69例患者的胆囊壁不规则，其中52例患有胆道闭锁。综合这些结果，胆囊超声检查在识别胆道闭锁方面的敏感性为90%，特异性为92.4%，阳性预测值为75.3%，阴性预测值为97.3%，准确率为91.9%。
