Jeffrey R B, Federle M P, Laing F C, Wall S, Rego J, Moss A A
AJR Am J Roentgenol. 1983 Jun;140(6):1179-83. doi: 10.2214/ajr.140.6.1179.
Computed tomography (CT) correctly diagnosed common bile duct stones in 19 (90%) of 21 surgically proven cases. CT demonstrated calculi in all 13 patients with calcium bilirubinate common duct stones and six of eight patients with predominantly cholesterol stones. There were two false-negative diagnoses in patients with cholesterol calculi scanned at 1 cm intervals. Cholesterol stones are nearly isodense with bile and may be difficult to visualize in the common duct by routine scanning techniques. There are three suggestive CT features of cholesterol common duct calculi: (1) abrupt termination of the distal common bile duct without an obstructing mass, (2) a faint rim of increased density along the peripheral margin of a low-density calculus, and (3) mottled areas of increased density centrally within a calculus elevating its CT number above values for normal bile. Modification of scanning technique to obtain high-resolution images of the extrahepatic biliary tree is stressed to optimize visualization of the above findings.
在21例经手术证实的病例中，计算机断层扫描（CT）正确诊断出21例中的19例（90%）胆总管结石。CT显示，13例胆红素钙性胆总管结石患者和8例以胆固醇结石为主的患者中的6例均有结石。在以1厘米间隔扫描的胆固醇结石患者中有2例假阴性诊断。胆固醇结石与胆汁的密度几乎相同，常规扫描技术可能难以在胆总管中显示。胆固醇性胆总管结石有三个CT特征提示：（1）胆总管远端突然截断而无阻塞性肿块；（2）低密度结石周边有一模糊的密度增高边缘；（3）结石中央有密度增高的斑驳区域，使其CT值高于正常胆汁。强调了改进扫描技术以获取肝外胆管树的高分辨率图像，以优化对上述发现的可视化。
