胆系B超、口服加静脉双重胆囊胆道造影与手术病理的对照研究(附133例分析)

本文报道133例胆系手术,术前所有病例均经B超和口服加静脉双重胆囊胆道造影检查,依据手术病理结果,对两种诊断方法进行评价。B超与口服加静脉双重胆囊阻道造影相比较,诊断胆囊结石敏感度分别为98.23％,74.76％;特异度80％,88.89％;准确度95.49％,77.69％结果显示,对于胆囊疾病的诊断,B超优于口服加静脉双重胆囊胆道造影。当B超检查未显示胆囊或不能作出结论,或临床高度疑有胆囊疾病而未证实时,酌情作口服胆囊造影。静脉胆道造影对诊断胆管病变价值不高,当临床疑有胆管病变,B超检查后可选用ERCP、PTC、术中胆道造影和术中B超来明确诊断。

Comparison Study of BUS, Oral Cholecystography and Intravenous Cholangiography, Operation and Pathology in 133 Cases of Biliary Tract Diseases

One hundred and thirty-three cases with biliary system diseases were operated.Before operation, ultrasonography(BUS) and the combination of oral cholecystography (OCG)and intravenous cholangiography (IVC) were performed in all of these patients. The two methods of diagnosis were evaluated on the basis of the results of operationand pathology. A comparison was made on BUS and the combination of OCG andIVC for the diagnosis of gallbladder calculi. The sensitivity for the former was98.23%, the specificity 80% and the accuracy 95.49%, while the sensitivity for thelatter was 74.76%, the specificity 88.89% and the accuracy 77.69%. The results reve- aled that BUS was superior to the combination of OCG and IVC in the diagnosis ofcholecystopathy. OCG was used when BUS had failed to reveal the gallbladder, showing inconclusive findings, or failed to demonstrate the biliary disease despite strongclinical suspicion. IVC was shown to be of little value in the diagnosis for cholepa-thies. When a pathology was susected, ERCP, PTC, operative cholangiography and operative ultrasonography could be used for definite diagnosis.