Vallon A G, Lees W R, Cotton P B
Gut. 1979 Jan;20(1):51-4. doi: 10.1136/gut.20.1.51.
Grey-scale ultrasonography was performed without access to detailed clinical information in a prospective study of 55 jaundiced patients. Forty-one were eventually proved to have an extrahepatic obstructive cause, and 14 had intrahepatic "medical" disease. Satisfactory ultrasound images were obtained in 54 patients, and the bile duct calibre was correctly reported in 53 (96%). All 14 medical cases were correctly identified. Two patients with gallstones (one with a normal sized duct) were incorrectly classified as medical. A specific and correct disease diagnosis was given in five of the 14 medical cases (one metastases, four cirrhosis), and in 23 of the 41 obstructive cases (12/14 pancreatic cancer, 5/15 gallstones), 5/5 bile duct compression, 1/3 bile duct cancer. Ultrasonography is safe, cheap, and acceptable to patients. It should be the first imaging investigation in jaundiced patients, providing remarkable diagnostic accuracy and important guidance for further management.
在一项对55例黄疸患者的前瞻性研究中，在未获取详细临床信息的情况下进行了灰阶超声检查。最终证明41例有肝外梗阻性病因，14例有肝内“内科”疾病。54例患者获得了满意的超声图像，53例（96%）正确报告了胆管内径。所有14例内科病例均被正确识别。2例胆结石患者（1例胆管大小正常）被错误分类为内科疾病。14例内科病例中有5例给出了具体且正确的疾病诊断（1例转移瘤，4例肝硬化），41例梗阻性病例中有23例（12/14胰腺癌，5/15胆结石，5/5胆管受压，1/3胆管癌）。超声检查安全、廉价且患者可接受。它应该是黄疸患者的首选影像学检查，具有显著的诊断准确性，并为进一步治疗提供重要指导。
