Bree R L
Department of Radiology, University of Michigan Medical Center, Ann Arbor 48109/0030, USA.
J Clin Ultrasound. 1995 Mar-Apr;23(3):169-72. doi: 10.1002/jcu.1870230304.
A positive sonographic Murphy sign, the presence of maximal tenderness elicited over a sonographically localized gallbladder, has been reported to be a helpful adjunctive finding in patients with proven acute cholecystitis who are evaluated with ultrasonography. We evaluated 200 patients with right upper quadrant pain, thought to be acute cholecystitis. Results of ultrasound examinations and subsequent follow-up were tabulated. The sensitivity of the sonographic Murphy sign in acute cholecystitis was 86% with a specificity of 35%, positive predictive value of 43%, and negative predictive value of 82%. The sensitivity of the sonographic findings, including stones, gallbladder wall edema, and pericholecystic fluid collections, was 93%, a specificity of 53%. The combination of the Murphy sign accompanied by gallstones yielded a specificity of 77%. The large number of false positives, and only moderate improvement in specificity when accompanied by gallstones, makes this sign unreliable in separating acute from chronic cholecystitis.
超声墨菲氏征阳性，即在超声定位的胆囊处引出最大压痛，据报道在超声检查的确诊急性胆囊炎患者中是一项有用的辅助发现。我们评估了200例右上腹疼痛、疑似急性胆囊炎的患者。将超声检查结果及后续随访情况制成表格。急性胆囊炎中超声墨菲氏征的敏感性为86%，特异性为35%，阳性预测值为43%，阴性预测值为82%。超声检查结果（包括结石、胆囊壁水肿和胆囊周围积液）的敏感性为93%，特异性为53%。墨菲氏征伴有胆结石时的特异性为77%。假阳性数量众多，且伴有胆结石时特异性仅适度提高，使得该体征在区分急性与慢性胆囊炎时不可靠。
