Lieberman D A, Krishnamurthy G T
Gastroenterology. 1986 Mar;90(3):734-43. doi: 10.1016/0016-5085(86)91131-5.
Biliary scintigraphy and ultrasound imaging were performed in 52 patients with suspected biliary tract pathology. Results were correlated with the findings of direct cholangiography. Several new innovations in scintigraphic technique were used. The combination of ultrasound imaging and scintigraphy correctly identified biliary tract obstruction in 17 of 19 patients, 12 of whom had dilated bile ducts on ultrasonography. Intrahepatic cholestasis was correctly diagnosed in 11 of 13 patients. Accurate discrimination between intrahepatic and extrahepatic cholestasis was achieved in 28 of 32 patients (88%) with the combined studies. Scintigraphy also provided a correct diagnosis of acute cholecystitis in all 9 patients with surgically confirmed disease. Eleven additional patients with gallbladder or pancreatic disease had normal bile ducts at scintigraphy, which was confirmed with cholangiography. When combined with ultrasound imaging, modern biliary scintigraphy can (a) provide excellent discrimination between intrahepatic and extrahepatic cholestasis and (b) help determine the need for subsequent invasive diagnostic studies in selected patients.
对52例疑似胆道疾病的患者进行了胆道闪烁显像和超声成像检查。结果与直接胆管造影的结果进行了对比。采用了几种闪烁显像技术的新创新方法。超声成像和闪烁显像相结合，在19例患者中的17例正确识别出胆道梗阻，其中12例在超声检查时有胆管扩张。13例患者中的11例被正确诊断为肝内胆汁淤积。联合检查在32例患者中的28例（88%）实现了肝内胆汁淤积和肝外胆汁淤积的准确鉴别。闪烁显像还对所有9例经手术证实患有急性胆囊炎的患者做出了正确诊断。另外11例患有胆囊或胰腺疾病的患者在闪烁显像时胆管正常，胆管造影证实了这一点。当与超声成像相结合时，现代胆道闪烁显像能够（a）对肝内胆汁淤积和肝外胆汁淤积进行出色的鉴别，以及（b）帮助确定部分患者后续进行侵入性诊断检查的必要性。
