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題 名 | Urgent Ultrasonography in Diagnosis of Choledocholithiasis--Analysis on Factors Influencing Stone Detection=總膽管結石之緊急超音波診斷--影響結石檢出率因素之研究 |
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作 者 | 葉永祥; 陳建華; 楊基滐; 方怡仁; 劉裕財; 吳志昇; 黃明和; | 書刊名 | 秀傳醫學雜誌 |
卷 期 | 7:1/2 2007.04[民96.04] |
頁 次 | 頁1-6 |
分類號 | 415.5392 |
關鍵詞 | 總膽管結石; 超音波; Choledocholithiasis; Ultrasonography; |
語 文 | 英文(English) |
中文摘要 | 目的:本研究在分析緊急超音波檢查對總膽管結石的檢出率,以及影響檢出率的因素。材料與方法:總共92個經由內視鏡膽胰攝影術證實的總膽管結石病人,他們在來院時就安排緊急超音波檢查。我們把檢查結果分為3組;第一組:超音波發現總膽管擴張及總膽管結石,第二組:超音波發現總膽管擴張但無法看到結石,第三組:超音波發現總膽管無擴張且無法看到結石。本研究就各組之間的總膽管大小、結石大小、與結石數目作比較分析。結果:緊急超音波檢查對總膽管結石的檢出率為57.6% (53/92)。第一組病人的平均總膽管直徑為16.8±6.1公釐,第二組為13.6±3.5公釐,第三組為6.5±1.0公釐(p<0.005)。總膽管結石的大小第一組為23.1±12.2公釐,第二組為13.0±5.3公釐,第三組為9.0±4.5公釐。(p<0.0005)此外,若總膽管結石大於或等於20公釐,則結石檢出率為86.4% (32/37);若結石大小界於10到19公釐之間,結石檢出率為44.1% (15/34);若結石小於10公釐,則結石檢出率為19.0% (4/21)。(p<0.0005)結論:緊急超音波檢查可以檢出57.6%的總膽管結石。影響總膽管結石檢出之因素包括總膽管徑的大小,以及總膽管結石的大小。 |
英文摘要 | PURPOSE: We observed the sensitivity of ultrasonography to detect choledocholithiasis under emergency basis and evaluated factors influencing the ultrasonic stone detection rate other than inadequate patient preparation. MATERIAL AND METHOD: 92 patients receiving urgent ultrasound examination and subsequently proved choledocholithiasis by endoscopic retrograde cholangiography were classified into 3 groups; Group Ⅰ: with ultrasound findings of ductal dilatation and intraductal stone, Group Ⅱ: ductal dilatation without visible stone by ultrasound, and Group Ⅲ: neither ductal dilatation nor intraductal stone visible. Common duct dimension and stone size were measured and compared in these 3 groups of patients as well. RESULT: The overall ultrasonic intraductal stone detection rate was 57.6% (53/92). The mean common duct dimension in Group Ⅰ was 16.8±6.1mm, in Group Ⅱ was 13.6±3.5mm, and in Group Ⅲ was 6.5±1.0mm (F test, p<0.005). The mean ductal stone dimension was 23.1±12.2mm in Group Ⅰ, 13.0±5.3mm in Group Ⅱ and 9.0±4.5mm in Group Ⅲ respectively (F test, p<0.0005). The stone detection rate was 86.4% (32/37) in patients with common duct stone size of≥20mm in diameter, 44.1% (15/34) in stone size between 10 to 19mm, and 19.0% (4/21) in stone size of<10mm in diameter. CONCLUSION: The urgent ultrasound had an overall sensitivity of 57.6% in detecting choledocholithiasis. Factors influencing ultrasonic detection rate of common duct stone other than inadequate patient preparation include common duct size and intraductal stone size. |
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