Khan M A, Khan A A, Shafqat F
Department of Radiology, Shaikh Zayed Postgraduate Medical Institute, Lahore.
J Pak Med Assoc. 1996 Sep;46(9):188-90.
Diagnostic accuracy of ultrasonography and cholangiography (ERCP/PTC) was compared in determining the site and nature of obstruction in obstructive jaundice. Ultrasound was performed in 50 patients with clinical diagnosis of obstructive jaundice. All patients subsequently underwent ERCP/PTC and/or surgery. ERCP was performed in 38 and PTC in 15 patients. The positive predictive value for the site and etiology of obstruction by ultrasonography was 94% and 86% respectively. In comparison, the cholangiography (ERCP/PTC) had positive predictive value of 100% in site and 98% in etiology. High degree of accuracy and non-invasiveness makes ultrasound as the primary radiological tool in the differential diagnosis of obstructive jaundice. ERCP is the gold standard for determining the precise level and cause of obstruction. PTC adds further to ultrasound based diagnosis of obstructive jaundice particularly in proximal obstruction and in ERCP failure.
对超声检查与胆管造影术（内镜逆行胰胆管造影术/经皮肝穿刺胆管造影术）在确定梗阻性黄疸梗阻部位及性质方面的诊断准确性进行了比较。对50例临床诊断为梗阻性黄疸的患者进行了超声检查。所有患者随后均接受了内镜逆行胰胆管造影术/经皮肝穿刺胆管造影术和/或手术。38例患者接受了内镜逆行胰胆管造影术，15例患者接受了经皮肝穿刺胆管造影术。超声检查对梗阻部位和病因的阳性预测值分别为94%和86%。相比之下，胆管造影术（内镜逆行胰胆管造影术/经皮肝穿刺胆管造影术）在梗阻部位的阳性预测值为100%，在病因方面的阳性预测值为98%。高度的准确性和非侵入性使超声成为梗阻性黄疸鉴别诊断的主要影像学工具。内镜逆行胰胆管造影术是确定梗阻确切水平和病因的金标准。经皮肝穿刺胆管造影术尤其在近端梗阻和内镜逆行胰胆管造影术失败时，可进一步辅助基于超声的梗阻性黄疸诊断。
