超声和CT诊断梗阻性黄疸的对比研究

Obstructive Jaundice: Compared Ultrasonography with Computed Tomography

目的 比较超声和CT诊断梗阻黄疸的价值。方法 接受了手术治疗的梗阻性黄疸患者 76例 ,超声检查 76例 ,CT检查 5 7例。梗阻部位分为三段 :上段为肝门处胆囊水平以上的肝内外胆管 ,中段为胰腺以上的胆总管 ,下段为胰腺及壶腹周围的胆管。将超声、CT对梗阻部位及病因的诊断结果分别与手术病理对照 ,所有数据均经统计学处理。结果 超声、CT对梗阻部位诊断准确率分别为 90 8%和 91 2 % ,对结石及恶性病变诊断准确率分别为94 7%和 89 6%、92 9%和 91 2 %。经 χ2 检验 ,这些差异不具有统计学意义。两种方法诊断良性占位性病变的准确性均不高 ,对可能的原因进行了分析。结论 超声是一种简便、安全、无创的影像学检查方法 ,可单独用于大多数梗阻性黄疸梗阻水平及病因的诊断 ;当超声诊断不明确或与临床诊断不一致时可考虑CT检查 ,以弥补超声诊断的不足 ,提高诊断的准确性。

Purpose 76 patients with obstructive jaundice were treated by surgical treatment. The value of Ultrasonography (US) to demonstrate the level and cause of obstructive jaundice were compared with Computed Tomography (CT). Methods US was performed in 76 patients,and CT in 57 patients. The level of biliary tract was defiended as pancreatic,suprapancreatic,or at the level of the porta hepatis. Causes of obstruction included choledocholithiasis,malignent tumor,pancreatitis and other benign tumor. The diagnosis of US and CT were compared with pathological results. Results Ths level of obstruction was correctly indicated by US in 90.8% of patients, and by CT in 91.2%. The cause was correctly indicated by US in 94.7% for choledocholithiasis and 89.6% for malignent tumor,by CT in 92.9% for choledocholithiasis and 91.2% for malignent tumor. We also found that both US and CT had a low accuracy in diagnosing obstructive jaundice caused by benign diseases. Conclusion US as a single radiological investigation is sufficient in the evaluation of the majority of patients with obstructive jaundice. CT shuold be done only when US gives equivocal findings. [