AIM: To evaluate the efficacy of intraductal ultrasonography (IDUS) in the diagnosis of non-opaque, common bile duct stones. METHODS: A total of 183 patients (102 males, mean age 73 years; 81 females, mean age 70 year...AIM: To evaluate the efficacy of intraductal ultrasonography (IDUS) in the diagnosis of non-opaque, common bile duct stones. METHODS: A total of 183 patients (102 males, mean age 73 years; 81 females, mean age 70 years) with suspected common bile duct stones diagnosed through abdominal computed tomography (CT), magnetic resonance imaging (MRI), and abdominal Type-B ultrasound were included in the study. The diagnosis was confirmed through endoscopic retrograde cholangiopancreatography (ERCP) followed by IDUS. RESULTS: A total of 183 patients with suspected common bile duct (CBD) stones were included in the study as follows: 36 patients with high-density CBD stones, 68 patients with sand-like stones, 44 patients with low-density stones, 21 patients with ampullary cancer, and 14 patients with pancreatic cancer. Conventional imaging revealed 124 cases of choledochectasia, and only 36 cases of suspected CBD stones; ERCP revealed 145 cases of CBD stones with three missed diagnoses. IDUS revealed 148 cases of CBD stones, 21 cases of ampullary tumors, and 14 cases of pancreatic cancer. CONCLUSION: IDUS was more effective in the diagnosis of bile duct stones than ERCP, upper abdominal CT or upper abdominal MRI.展开更多
Objective: Computerized tomography (CT) plays an important role in the diagnosis of diseases of biliary tract. Recently, three dimensions (3D) spiral CT imaging has been used in surgical diseases gradually. This study...Objective: Computerized tomography (CT) plays an important role in the diagnosis of diseases of biliary tract. Recently, three dimensions (3D) spiral CT imaging has been used in surgical diseases gradually. This study was designed to evaluate the diagnostic value of 3D spiral CT imaging of cholangiopancreatic ducts on obstructive jaundice. Methods: Thirty patients with obstructive jaundice had received B-mode ultrasonography, CT, percutaneous transhepatic cholangiography (PTC) or endoscopic retrograde cholangiopancreatography (ERCP), and 3D spiral CT imaging of cholangiopancreatic ducts preoperatively. Then the diagnose accordance rate of these examinational methods were compared after operations. Results: The diagnose accordance rate of 3D spiral CT imaging of cholangiopancreatic ducts was higher than those of B-mode ultrasonography, CT, or single PTC or ERCP, which showed clear images of bile duct tree and pathological changes. As to malignant obstructive jaundice, this examinational technique could clearly display the adjacent relationship between tumor and liver tissue, biliary ducts, blood vessels, and intrahepatic metastases. Conclusion: 3D spiral CT imaging of cholangiopancreatic ducts has significant value for obstructive diseases of biliary ducts, which provides effective evidence for the feasibility of tumor-resection and surgical options.展开更多
基金Supported by Shanghai Natural Science Foundation, No 08411962900
文摘AIM: To evaluate the efficacy of intraductal ultrasonography (IDUS) in the diagnosis of non-opaque, common bile duct stones. METHODS: A total of 183 patients (102 males, mean age 73 years; 81 females, mean age 70 years) with suspected common bile duct stones diagnosed through abdominal computed tomography (CT), magnetic resonance imaging (MRI), and abdominal Type-B ultrasound were included in the study. The diagnosis was confirmed through endoscopic retrograde cholangiopancreatography (ERCP) followed by IDUS. RESULTS: A total of 183 patients with suspected common bile duct (CBD) stones were included in the study as follows: 36 patients with high-density CBD stones, 68 patients with sand-like stones, 44 patients with low-density stones, 21 patients with ampullary cancer, and 14 patients with pancreatic cancer. Conventional imaging revealed 124 cases of choledochectasia, and only 36 cases of suspected CBD stones; ERCP revealed 145 cases of CBD stones with three missed diagnoses. IDUS revealed 148 cases of CBD stones, 21 cases of ampullary tumors, and 14 cases of pancreatic cancer. CONCLUSION: IDUS was more effective in the diagnosis of bile duct stones than ERCP, upper abdominal CT or upper abdominal MRI.
基金Supported by a grant of Jiangxi Province Scientific Technologic Foundation (No. E990611)
文摘Objective: Computerized tomography (CT) plays an important role in the diagnosis of diseases of biliary tract. Recently, three dimensions (3D) spiral CT imaging has been used in surgical diseases gradually. This study was designed to evaluate the diagnostic value of 3D spiral CT imaging of cholangiopancreatic ducts on obstructive jaundice. Methods: Thirty patients with obstructive jaundice had received B-mode ultrasonography, CT, percutaneous transhepatic cholangiography (PTC) or endoscopic retrograde cholangiopancreatography (ERCP), and 3D spiral CT imaging of cholangiopancreatic ducts preoperatively. Then the diagnose accordance rate of these examinational methods were compared after operations. Results: The diagnose accordance rate of 3D spiral CT imaging of cholangiopancreatic ducts was higher than those of B-mode ultrasonography, CT, or single PTC or ERCP, which showed clear images of bile duct tree and pathological changes. As to malignant obstructive jaundice, this examinational technique could clearly display the adjacent relationship between tumor and liver tissue, biliary ducts, blood vessels, and intrahepatic metastases. Conclusion: 3D spiral CT imaging of cholangiopancreatic ducts has significant value for obstructive diseases of biliary ducts, which provides effective evidence for the feasibility of tumor-resection and surgical options.