Lesch P
Rontgenblatter. 1978 Sep;31(9):539-44.
Since endoscopy became part of routine diagnostic measures in epigastric diseases, less weight has been attached to x-ray examinations, although the range of application of radiological diagnosis has widened rather than narrowed. In the first place this must be ascribed to the combined diagnostic methods of endoscopic retrograde cholangio-pancreaticography (ERCP), percutaneous transhepatic cholangiography (PTC) and to a limited extent also to percutaneous transjugular cholangiography (PTJC). All three methods are typical examples of the increasing importance of teamwork between the internist engaged in gastroenterology and the radiologist. Other methods, too, the application of which is being practised both by internists and radiologists, are growing in importance, such as sonography and computerised tomography. However, the decisive factor is that today the indication for radiological examinations can be determined in a much more selective fashion than only a few years age: enzymological and serological laboratory and functional investigations are now being used as routine and screening methods and will enable the internist to direct pointed questions at the radiologist. X-ray diagnostics can hold its own within the framework of internistic general diagnostics only if it pays more attention to the more refined examination methods.
自从内窥镜检查成为上腹部疾病常规诊断手段的一部分以来,X线检查的重要性有所下降,尽管放射诊断的应用范围扩大了而非缩小了。首先,这必须归因于内镜逆行胰胆管造影(ERCP)、经皮肝穿刺胆管造影(PTC)以及在一定程度上经皮经颈静脉胆管造影(PTJC)等联合诊断方法。这三种方法都是从事胃肠病学的内科医生与放射科医生之间团队合作重要性日益增加的典型例子。其他方法,如超声检查和计算机断层扫描,内科医生和放射科医生都在应用,其重要性也在不断提高。然而,决定性因素是,如今与几年前相比,放射检查的适应证能够以更具选择性的方式确定:酶学和血清学实验室检查及功能检查现在已作为常规和筛查方法使用,这将使内科医生能够向放射科医生提出针对性的问题。只有更加注重更精细的检查方法,X线诊断才能在内科综合诊断框架内保持自身的地位。