Cooperberg P L, Li D, Wong P, Cohen M M, Burhenne H J
Radiology. 1980 Apr;135(1):141-4. doi: 10.1148/radiology.135.1.7360952.
High-resolution real-time ultrasound sector scanning is helpful in showing the normal common hepatic duct. The authors evaluated the accuracy of using a 4-mm internal diameter as the upper limit of normal in evaluation of obstruction. Of 98 patients with jaundice or right-upper-quadrant pain whose duct exceeded 4 mm, obstruction was proved in 84. Fourteen patients had no radiographic or pathological evidence of obstruction, but 7 had undergone cholecystectomy and clinical evidence suggested another 6 had passed a stone before or after the ultrasound study. Of 72 patients with a duct greater than or equal to 4 mm, only one had obstruction; a mass blocked the right and left hepatic ducts. The sensitivity of the test is 99%, the specificity 87%. Thus if the common hepatic duct is more than 4 mm in internal diameter on ultrasound, extrahepatic biliary obstruction is probably present.
高分辨率实时超声扇形扫描有助于显示正常的肝总管。作者评估了以4毫米内径作为正常上限在评估梗阻时的准确性。在98例黄疸或右上腹疼痛且肝总管直径超过4毫米的患者中，84例被证实存在梗阻。14例患者没有影像学或病理学梗阻证据，但7例曾接受胆囊切除术，另有6例临床证据提示在超声检查之前或之后曾排出结石。在72例肝总管直径大于或等于4毫米的患者中，只有1例存在梗阻；一个肿块阻塞了左右肝管。该检查的敏感性为99%，特异性为87%。因此，如果超声显示肝总管内径超过4毫米，则可能存在肝外胆管梗阻。
