Matzen P, Malchow-Møller A, Brun B, Grønvall S, Haubek A, Henriksen J H, Laursen K, Lejerstofte J, Stage P, Winkler K, Juhl E
Gastroenterology. 1983 Jun;84(6):1492-7.
In order to compare their capacity to visualize the bile ducts, ultrasonography, computed tomography, and cholescintigraphy were performed in 56 consecutive jaundiced patients in whom extrahepatic cholestasis was clinically suspected. The predictions as to the patency of the large bill ducts were compared with the final diagnoses made on the basis of direct cholangiography together with autopsy, biopsy, operative findings, and the clinical course. Thirty-nine patients (70%) had obstructed bile ducts, and 17 (30%) had patent large bile ducts. Using a simple scoring scale with 112 points as the maximum, ultrasonography obtained 72 points, computed tomography received 56 points, and cholescintigraphy totalled 37 points. Nonsignificant trends were found in favor of ultrasonography as compared with computed tomography and of computed tomography as compared with cholescintigraphy (p greater than 0.05), whereas ultrasonography was significantly better than cholescintigraphy (p = 0.01). However, because computed tomography is expensive and may imply a higher number of secondary direct cholangiographies than ultrasonography, we recommend ultrasonography as the first choice for noninvasive bile duct visualization. Computed tomography is an alternative method, whereas cholescintigraphy cannot be recommended.
为比较超声检查、计算机断层扫描和胆管闪烁造影术显示胆管的能力，对56例临床怀疑有肝外胆汁淤积的连续性黄疸患者进行了上述检查。将对大胆管通畅情况的预测结果与基于直接胆管造影以及尸检、活检、手术所见和临床病程得出的最终诊断结果进行比较。39例患者（70%）胆管梗阻，17例（30%）大胆管通畅。使用一个最高分为112分的简单评分量表，超声检查得72分，计算机断层扫描得56分，胆管闪烁造影术总计得37分。与计算机断层扫描相比，发现有利于超声检查的无显著意义的趋势；与胆管闪烁造影术相比，有利于计算机断层扫描的趋势（p>0.05），而超声检查明显优于胆管闪烁造影术（p = 0.01）。然而，由于计算机断层扫描费用高，可能意味着比超声检查需要更多的二次直接胆管造影，我们建议将超声检查作为无创胆管显像的首选方法。计算机断层扫描是一种替代方法，而胆管闪烁造影术不推荐使用。
