Barakos J A, Ralls P W, Lapin S A, Johnson M B, Radin D R, Colletti P M, Boswell W D, Halls J M
Radiology. 1987 Feb;162(2):415-8. doi: 10.1148/radiology.162.2.3797654.
Computed tomography (CT) is often the first imaging modality used in the diagnosis of patients with suspected abdominal disease. While it is known that early generation CT scanners often detect gallstones, the detection rate of newer equipment is not widely known. Abdominal CT scans of 226 patients who had undergone ultrasonographic (US) studies of the gallbladder were reviewed in a blinded study to determine the accuracy of state-of-the-art CT scanning equipment in the detection of cholelithiasis. Of 110 patients with US or surgical evidence of cholelithiasis, gallstones were demonstrated on CT images of 87 (79.1% sensitivity). Overall accuracy was 89.8%, while specificity was 100%. On CT images stones could appear densely (48.3%) or slightly (11.5%) calcified, as an area with a rim of increased density (21.8%), as an area of soft-tissue density (14.9%), or as an area of low density (3.4%). Stone size, stone density, section incrementation, and the pericholecystic anatomy affected the detection rate. Understanding the spectrum of findings and the other factors involved can optimize success of diagnosis of cholelithiasis on the basis of CT examinations.
计算机断层扫描（CT）通常是疑似腹部疾病患者诊断中首先使用的成像方式。虽然已知早期的CT扫描仪经常能检测到胆结石，但新型设备的检测率并不广为人知。在一项盲法研究中，对226例接受过胆囊超声（US）检查的患者的腹部CT扫描进行了回顾，以确定最先进的CT扫描设备检测胆结石的准确性。在110例有超声或手术证据证明患有胆结石的患者中，87例（敏感性为79.1%）的CT图像上显示有胆结石。总体准确率为89.8%，特异性为100%。在CT图像上，结石可表现为高密度（48.3%）或低密度（11.5%）钙化，表现为密度增加边缘的区域（21.8%），表现为软组织密度区域（14.9%），或表现为低密度区域（3.4%）。结石大小、结石密度、层厚增量和胆囊周围解剖结构会影响检测率。了解发现的范围和其他相关因素可以优化基于CT检查的胆结石诊断成功率。
