Neitlich Tyler, Neitlich Jeffrey
Department of Radiology, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL, 33140, USA.
Obes Surg. 2009 Feb;19(2):207-210. doi: 10.1007/s11695-008-9582-z. Epub 2008 Jul 17.
The purpose of this study was to compare computed tomography (CT) cholecystography and ultrasound for gallstone detection in preoperative bariatric surgery patients.
The study included 16 asymptomatic prebariatric surgery patients. On the same day, each patient underwent abdominal CT 4 h after IV cholecystograffin injection, and gallbladder ultrasound. CT and ultrasounds were reviewed by two independent, blinded radiologists, and scored as follows: no gallstones, possible gallstones, definite gallstones, indeterminate. CT and ultrasound results were compared.
Ultrasound detected definite gallstones in three patients, possible gallstones in one patient, and no gallstones in ten patients. Two scans were considered indeterminate. CT cholecystography detected definite gallstones in six patients, possible gallstones in zero patients, and no gallstones in nine patients, and was indeterminate in one patient. All three patients with gallstones seen sonographically had definite gallstones on CT. The patient with possible gallstones detected sonographically had definite stones detected at CT. One of the two patients with indeterminate ultrasounds had gallstones detected at CT. The other patient had both studies indeterminate. One patient with no gallstones sonographically had definite gallstones at CT. No patients with a negative CT had gallstones seen on ultrasound. Nine patients had no gallstones on either modality.
CT cholecystography is more sensitive and specific for the detection of gallstones in the obese population. CT cholecystography should be considered in place of ultrasound in the preoperative workup of these patients.
本研究的目的是比较计算机断层扫描（CT）胆囊造影和超声在肥胖症手术患者术前胆结石检测中的应用。
该研究纳入了16例无症状的肥胖症手术前患者。同一天，每位患者在静脉注射胆囊造影剂4小时后接受腹部CT检查以及胆囊超声检查。由两名独立的、不知情的放射科医生对CT和超声检查结果进行评估，并按以下标准评分：无胆结石、可能有胆结石、确诊有胆结石、结果不确定。对CT和超声检查结果进行比较。
超声检查发现3例确诊有胆结石，1例可能有胆结石，10例无胆结石。有2次扫描结果被认为不确定。CT胆囊造影检查发现6例确诊有胆结石，0例可能有胆结石，9例无胆结石，1例结果不确定。超声检查发现有胆结石的3例患者在CT检查中均确诊有胆结石。超声检查发现可能有胆结石的患者在CT检查中确诊有胆结石。超声检查结果不确定的2例患者中有1例在CT检查中发现有胆结石。另1例患者两项检查结果均不确定。超声检查无胆结石的1例患者在CT检查中确诊有胆结石。CT检查结果为阴性的患者在超声检查中均未发现胆结石。9例患者两种检查方法均未发现胆结石。
CT胆囊造影在肥胖人群胆结石检测中更具敏感性和特异性。在这些患者的术前检查中，应考虑用CT胆囊造影代替超声检查。
