Litviakov A M
Ter Arkh. 1987;59(2):123-6.
The author presented methods and results of ultrasonic diagnosis of concrements in intrahepatic (4), lobar (5), cystic (24) and common bile (20) ducts. In technically difficult cases the starting point of an acoustic shadow route was the only sign permitting concrement localization in the duct. Indirect signs of occluding choledocholithiasis were dilatated lumen of intrahepatic and proximal (with respect to the site of occlusion) extrahepatic ducts, a concrement filled cavity and the tense gall bladder wall, the absence of echographic signs of tumor involvement of the peritoneal cavity organs. The dilatation of the ducts and gall bladder cavity were more noticeable in patients with a long history of cholestasis. The lamination of the gall bladder content into zones of different echogenicity, the filling of the dilatated ducts with the content of inhomogeneous acoustic transparency indicated the complication of occluding choledocholithiasis by purulent cholangitis.
作者介绍了肝内（4例）、叶间（5例）、胆囊（24例）及胆总管（20例）结石的超声诊断方法及结果。在技术上困难的病例中，声影路径的起始点是唯一能在胆管内定位结石的征象。阻塞性胆总管结石的间接征象为肝内及近端（相对于阻塞部位）肝外胆管管腔扩张、结石填充腔及胆囊壁紧张，无腹膜腔器官受肿瘤侵犯的超声征象。胆管和胆囊腔的扩张在有长期胆汁淤积病史的患者中更明显。胆囊内容物分层为不同回声区，扩张的胆管内充满声学透明度不均匀的内容物，提示阻塞性胆总管结石并发脓性胆管炎。
