胆道系疾患における超音波検査の有用性について

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In order to demonstrate the clinical value of ultrasonography, we examined 218 cases with biliary tract diseases, of which 152 had cholecystolithiasis, 23 had choledocholithiasis, 33 patients had cholecystitis, 3 had gall bladder cancer, 5 patients had bile duct carcinoma and 2 had gall bladder polyps. The accuracy of cholecystolithiasis diagnosis was as high as 94.1% (142 out of 152 patients) by ultrasonography. Twelve cases out of 23 (52.2%) with choledocholithiasis were correctly diagnosed and the dilated extrahepatic bile ducts, with diameters of over 8 mm, were visualized in 20 of the cases (87.0%) examined by this method. The diagnostic accuracy of 87.0% was approximately equal to that of FRCP. Ultrasonography was accurate as much as 93.9% of the time in the diagnosis of cholecystitis in 33 patients, however, 7 other hepatic diseases were misjudged using ultrasonography. Seventeen patients were diagnosed as having gall bladder cancer by ultrasonography, however, only 3 of these were, in fact, true cases of carcinoma, and the rest were cholecystitis or other hepatic diseases. It was difficult for us to differentiate gall bladder cancer from cholecystitis by employing ultrasonography only. Accuracy of bile duct carcinoma diagnosis was as low as 40.0%, though the location of obstructions was visualized in all cases. By ultrasonography, we found two cases with gall bladder polyps, but we mistook 5 cases of gall stones and gall bladder sludge as polyps. In conclusion, linear array electronic real-time ultrasonography proved to be effective for the diagnosis of biliary tract diseases.

胆道系疾患における超音波検査の有用性について

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