Pasanen P A, Partanen K, Pikkarainen P, Alhava E, Pirinen A, Janatuinen E
Dept. of Surgery, Kuopio University Hospital, Finland.
Scand J Gastroenterol. 1991 Nov;26(11):1157-64. doi: 10.3109/00365529108998608.
The purpose of this prospective study was to investigate the diagnostic accuracy of ultrasound (US), computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP) in the distinction between extrahepatic and intrahepatic causes of jaundice. The limit for the inclusion to the study was defined as a serum bilirubin concentration greater than or equal to 40 mumol/l. Altogether 187 jaundiced patients were studied. The sensitivities of US, CT, and ERCP were 63%, 77%, and 87%, respectively. The differences between all these methods were statistically significant. The specificities and positive predictive values were high, reaching 96-99%, but the negative predictive values were low, ranging between 38% and 60%. Choledochal stone disease constituted the main etiology of false-negative studies in all investigations. Imaging procedures have a prominent role in the diagnostic study of the jaundiced patient, but it is obvious that their diagnostic accuracy may vary between institutions because of the variance in local experience and expertise, and because of the differences in diseases causing jaundice.
这项前瞻性研究的目的是调查超声（US）、计算机断层扫描（CT）和内镜逆行胰胆管造影（ERCP）在区分黄疸肝外和肝内病因方面的诊断准确性。该研究的纳入标准定义为血清胆红素浓度大于或等于40μmol/l。总共对187例黄疸患者进行了研究。US、CT和ERCP的敏感性分别为63%、77%和87%。所有这些方法之间的差异具有统计学意义。特异性和阳性预测值较高，达到96 - 99%，但阴性预测值较低，在38%至60%之间。在所有检查中，胆总管结石病是假阴性研究的主要病因。成像检查在黄疸患者的诊断研究中起着重要作用，但很明显，由于当地经验和专业知识的差异以及导致黄疸的疾病差异，其诊断准确性在不同机构可能有所不同。
