Da Silva F, Boudghene F, Lecomte I, Delage Y, Grange J D, Bigot J M
Service de Radiologie, Hôpital Tenon, Paris, France.
AJR Am J Roentgenol. 1993 Jun;160(6):1205-7. doi: 10.2214/ajr.160.6.8498216.
The purpose of this study was to determine the prevalence and cause of an echogenic nodule in the distal end of the common bile duct seen on sonograms in patients who have AIDS-related cholangitis.
Sonograms of the liver and bile ducts were obtained in 15 patients who had AIDS-related cholangitis. Both 3.75- and 5-MHz transducers were used in all patients. The appearance of an echogenic nodule in the distal end of the common bile duct was compared with the results of endoscopic retrograde cholangiograms in 12 patients and with biopsies of the papilla of Vater in the first five cases.
Sonograms showed a hyperechoic nodule in the distal end of the common bile duct in 10 of the 15 cases. Visualization was improved after oral administration of water. The finding correlated with edema of the papilla of Vater noted on retrograde cholangiograms in eight cases. Biopsy of the papilla of Vater in five cases showed an inflammatory infiltrate. The nodule became smaller in one patient when cholestasis improved after treatment for cryptosporidiosis.
An echogenic nodule was detected in the distal end of the common bile duct on sonograms in two thirds of patients who had AIDS-related cholangitis. Our findings suggest the abnormality is caused by edema of the papilla of Vater.
本研究的目的是确定艾滋病相关性胆管炎患者超声检查中所见胆总管远端强回声结节的患病率及病因。
对15例艾滋病相关性胆管炎患者进行肝脏和胆管的超声检查。所有患者均使用3.75兆赫和5兆赫的换能器。将12例患者胆总管远端强回声结节的表现与内镜逆行胆管造影结果进行比较，并将前5例患者的十二指肠乳头活检结果与之对比。
15例患者中，10例超声检查显示胆总管远端有高回声结节。口服水后显影改善。该发现与8例逆行胆管造影中所见十二指肠乳头水肿相关。5例十二指肠乳头活检显示有炎性浸润。1例隐孢子虫病患者经治疗胆汁淤积改善后，结节变小。
三分之二的艾滋病相关性胆管炎患者超声检查发现胆总管远端有强回声结节。我们的研究结果提示该异常是由十二指肠乳头水肿所致。
