Brakel K, den Toom R, Laméris J S, Nijs H G, van der Hul R L, Plaisier P W, Terpstra O T, Schütte H E
Dept. of Radiology, Dijkzigt University Hospital, Rotterdam, The Netherlands.
Scand J Gastroenterol. 1993 Mar;28(3):197-201. doi: 10.3109/00365529309096071.
To establish the value of ultrasound (US) in the follow-up of patients treated with extracorporeal shockwave lithotripsy (ESWL), the results of 484 US examinations of 87 patients were analyzed and related to the results of ESWL. Reliability of US in assessing efficacy was investigated by comparing consecutive US examinations. Unreliable US results were found in 36 patients (41%); in 7 patients US failed to demonstrate fragments. In nine patients (10%) unreliable US findings contributed to delayed retreatment with ESWL. To prevent errors in treatment regimen, verification of US findings is advised in case no fragments or fragments < 5 mm are found. In 22 patients (25%) US findings appeared indicative of hampered stone migration. Only 2 of these 22 patients (9.1%) became free of stones, compared with 32 of the remaining 65 patients (49.3%) (p < 0.01), even though both groups had similar initial stone characteristics and similar time of follow-up. US findings such as a contracted gallbladder or a common bile duct > 7 mm therefore indicate poor efficacy of ESWL.
为确定超声（US）在体外冲击波碎石术（ESWL）治疗患者随访中的价值，分析了87例患者484次超声检查结果，并与ESWL结果相关联。通过比较连续的超声检查来研究超声评估疗效的可靠性。在36例患者（41%）中发现超声结果不可靠；在7例患者中，超声未显示碎片。在9例患者（10%）中，不可靠的超声检查结果导致ESWL延迟再次治疗。为防止治疗方案出现错误，若未发现碎片或碎片<5 mm，建议对超声检查结果进行核实。在22例患者（25%）中，超声检查结果显示结石迁移受阻。这22例患者中只有2例（9.1%）结石清除，而其余65例患者中有32例（49.3%）结石清除（p<0.01），尽管两组患者初始结石特征和随访时间相似。因此，超声检查结果如胆囊收缩或胆总管>7 mm提示ESWL疗效不佳。
