Neitlich J D, Topazian M, Smith R C, Gupta A, Burrell M I, Rosenfield A T
Department of Diagnostic Imaging, Yale University School of Medicine, New Haven, CT 06510, USA.
Radiology. 1997 Jun;203(3):753-7. doi: 10.1148/radiology.203.3.9169700.
To compare unenhanced helical computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) in the detection of common bile duct calculi.
Within 13 months, 51 patients (aged 18-94 years) with clinically suspected choledocholithiasis underwent unenhanced helical CT immediately before undergoing ERCP. CT scans were evaluated for the presence of bile duct stones, ampullary stones, the gallbladder and gallbladder stones, intrahepatic biliary dilatation, and the size of the bile duct at the porta hepatis and in the pancreatic head. ERCP images were evaluated for the presence of bile duct or ampullary stones, as well as for biliary dilatation.
Unenhanced helical CT depicted common bile duct stones in 15 of 17 patients found to have stones at ERCP. Three patients had stones impacted at the ampulla, all of which were detected with CT. In addition, there was one false-positive finding at CT. CT had a sensitivity of 88%, a specificity of 97%, and an accuracy of 94% in the diagnosis of common bile duct stones.
Unenhanced helical CT is useful for evaluating suspected choledocholithiasis.
比较非增强螺旋计算机断层扫描（CT）和内镜逆行胰胆管造影（ERCP）在检测胆总管结石方面的效果。
在13个月内，51例临床怀疑患有胆总管结石的患者（年龄18 - 94岁）在接受ERCP之前立即进行了非增强螺旋CT检查。对CT扫描结果进行评估，以确定是否存在胆管结石、壶腹结石、胆囊及胆囊结石、肝内胆管扩张以及肝门部和胰头部胆管的大小。对ERCP图像进行评估，以确定是否存在胆管或壶腹结石以及胆管扩张情况。
在17例经ERCP检查发现有结石的患者中，非增强螺旋CT显示出15例胆总管结石。3例患者的结石嵌顿在壶腹部，所有这些均被CT检测到。此外，CT检查有1例假阳性结果。CT诊断胆总管结石的敏感性为88%，特异性为97%，准确性为94%。
非增强螺旋CT对评估疑似胆总管结石有用。
