Burrell M I, Zeman R K
Yale University School of Medicine, New Haven, CT 06510.
J Clin Gastroenterol. 1988 Apr;10(2):123-6.
We review the discrepancies and the reasons for them, in two articles in this issue of the Journal to conclude that clinical findings hold the key to selection of the proper imaging test in biliary obstruction. Cholescintigraphy is a more rewarding approach in detecting low grade obstruction, as by common duct stones, whereas in the patient with prolonged painless jaundice, and the high likelihood of a malignancy, computed tomography or ultrasound will yield the best results. Because of the potential for noninvasive imaging to miss choledocholithiasis and because of ever increasing therapeutic options, direct cholangiography will continue to be the mainstay in definition evaluation of the biliary tract.
我们在本期《杂志》的两篇文章中回顾了差异及其原因，得出结论：临床发现是选择胆管梗阻合适影像学检查的关键。在检测如胆总管结石导致的低度梗阻时，胆管闪烁显像术是一种更有价值的方法，而对于有长期无痛性黄疸且极有可能患恶性肿瘤的患者，计算机断层扫描或超声检查会得出最佳结果。由于无创成像可能漏诊胆总管结石，且治疗选择不断增加，直接胆管造影术仍将是胆管评估的主要手段。
