Fiegler W, Schörner W, Felix R
Rontgenblatter. 1984 Sep;37(9):327-32.
The effectiveness of ultrasound, computed tomography, hepatobiliary scintigraphy and nuclear magnetic resonance in diseases of the biliary tract is described. Ultrasound should be the first examination in clinical suspicion of cholelithiasis and has a higher accuracy than oral cholecystography. Computed tomography is very expensive and should be carried out in suspected gallbladder carcinoma, cholecystitis with abscess formation, tumour in the porta hepatis and pancreatic head and in sonographically unclear cases. Nuclear magnetic resonance can determine the ability of the gallbladder to concentrate bile. Ultrasound can distinguish with high accuracy between obstructive and inflammatory jaundice. In clinical suspicion of bile duct lesions an infusion cholangiogram must be carried out, if bilirubin is lower than 5 mg%; if bilirubin is higher, an ERC or PTC should be performed. If in biliary obstruction a suspicion of tumour in porta hepatis or head of the pancreas is present, computed tomography should be effected.
本文描述了超声、计算机断层扫描、肝胆闪烁造影及核磁共振在胆道疾病中的有效性。超声应作为临床怀疑胆石症时的首选检查，其准确性高于口服胆囊造影。计算机断层扫描费用高昂，应在怀疑胆囊癌、伴有脓肿形成的胆囊炎、肝门部及胰头部肿瘤以及超声检查不明确的病例中进行。核磁共振可测定胆囊浓缩胆汁的能力。超声能高精度地区分梗阻性黄疸和炎性黄疸。临床怀疑胆管病变时，若胆红素低于5mg%，必须进行静脉胆管造影；若胆红素较高，则应进行内镜逆行胰胆管造影（ERC）或经皮肝穿刺胆管造影（PTC）。若在胆道梗阻时怀疑肝门部或胰头部有肿瘤，应进行计算机断层扫描。
