Fu X B
Department of Surgery, Third Teaching Hospital, Beijing Medical University.
Zhonghua Yi Xue Za Zhi. 1993 Feb;73(2):81-4, 126.
The efficacy of oral cholelitholytic therapy with chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA) in 137 patients with gallstones was compared with their CT patterns. The best dissolving results were obtained from patients with the stones in isodense and faint category (< 50 Hu) on CT. All the stones with high density or heterogeneous calcification on CT were insoluble, therefore, they were contraindicated for oral cholelitholytic therapy. According to the above, criteria, the rate for dissolution ranged from 27.7% (38/137) to 66.7% (38/57), and that for complete dissolution ranged from 9.49% (13/137) to 40.7% (11/27). The attenuation value classified as complete dissolution ranged from -2 to 35 Hu(14 +/- 12 Hu, n = 13). CT analysis improved the predictability of dissolving gallstones in comparison with plain abdominal radiography or oral cholecystography (OCG). Besides, gallstones, which showed no obvious filling defect on OCG but distinct echo and shadow on B-type ultrasonography, were also insoluble.
对137例胆结石患者口服鹅去氧胆酸(CDCA)和熊去氧胆酸(UDCA)进行溶石治疗的疗效与其CT表现进行了比较。CT表现为等密度和低密度(<50 Hu)的结石患者溶石效果最佳。CT表现为高密度或不均匀钙化的所有结石均不能溶解,因此,这些结石患者禁忌口服溶石治疗。根据上述标准,溶解率为27.7%(38/137)至66.7%(38/57),完全溶解率为9.49%(13/137)至40.7%(11/27)。分类为完全溶解的衰减值范围为-2至35 Hu(14±12 Hu,n = 13)。与腹部平片或口服胆囊造影(OCG)相比,CT分析提高了胆结石溶解的可预测性。此外,在OCG上无明显充盈缺损但在B型超声上有明显回声和阴影的胆结石也不能溶解。