Linghu En-Qiang, Cheng Liu-Fang, Wang Xiang-Dong, Wang Zhi-Qiang, Yang Yun-Sheng, Li Wen, Cai Feng-Chun, Wang Hong-Zhi, Du Hong, Meng Jiang-Yun
Department of Digestive Medicine, 301 Hospital, Beijing 100853, China. lh_
Hepatobiliary Pancreat Dis Int. 2004 Feb;3(1):129-32.
Intraductal ultrasonography (IDUS) is highly accurate in detection of extrahepatic bile duct stones. This study was to compare the accuracy of IDUS and endoscopic retrograde cholangiography (ERC) in the diagnosis of extrahepatic bile duct stones.
Thirty patients suspected of extrahepatic bile duct stones on B ultrasonography, CT, or MRI were enrolled for study. ERC was performed using a Fujinon duodenoscope (ED-410XT, ED-410Xu), then IDUS was done by inserting a Fujinon microprobe (PL2220-15) through the endoscopic biopsy channel to detect the extrahepatic bile duct. Finally stones in the extrahepatic bile duct were detected and extracted by endoscopic sphincterotomy (EST).
Among the 30 patients, 26 were diagnosed as having cholelithiasis accurately through ERC. In one patient the stone detected by ERC was really floccule. Misdiagnosis happened in 2 patients with extrahepatic bile duct stones. So the overall accuracy and sensitivity of ERC in the diagnosis of extrahepatic bile duct stones were 86.7% (26/30) and 92.9% (26/28) respectively. In contrast, IDUS showed the results of diagnosis were in consistent with those of EST stone extraction. Its accuracy and sensitivity in the diagnosis of extrahepatic bile duct stones were 100% (30/30) and 100% (28/28) respectively.
IDUS which is superior to ERC in diagnosing extrahepatic bile duct stones can avoid the visual error of ERC.
导管内超声检查（IDUS）在检测肝外胆管结石方面具有高度准确性。本研究旨在比较IDUS和内镜逆行胆管造影（ERC）在诊断肝外胆管结石中的准确性。
选取30例经B超、CT或MRI怀疑有肝外胆管结石的患者进行研究。使用富士能十二指肠镜（ED - 410XT、ED - 410Xu）进行ERC，然后通过内镜活检通道插入富士能微探头（PL2220 - 15）进行IDUS以检测肝外胆管。最后通过内镜括约肌切开术（EST）检测并取出肝外胆管中的结石。
30例患者中，26例通过ERC被准确诊断为胆石症。1例患者经ERC检测出的结石实际为絮状物。2例肝外胆管结石患者出现误诊。因此，ERC诊断肝外胆管结石的总体准确率和敏感性分别为86.7%（26/30）和92.9%（26/28）。相比之下，IDUS显示的诊断结果与EST结石取出结果一致。其诊断肝外胆管结石的准确率和敏感性分别为100%（30/30）和100 %（28/28）。
在诊断肝外胆管结石方面优于ERC的IDUS可避免ERC的视觉误差。
