Common bile duct stones on multidetector computed tomography: Attenuation patterns and detectability
Common bile duct stones on multidetector computed tomography: Attenuation patterns and detectability
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DOI：
10.3748/wjg.v19.i11.1788
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发表时间：
2013-03-21
影响因子：
4.3
通讯作者：
Han, Sok Won
中科院分区：
文献类型：
--
作者：
Kim, Chang Whan;Chang, Jae Hyuck;Han, Sok Won
目的：探讨多排计算机断层扫描（MDCT）对胆总管（CBD）结石的衰减模式和可检出率。 方法：2010年3月至2012年2月期间，对191例怀疑有CBD结石并接受MDCT和内镜逆行胰胆管造影（ERCP）的患者进行回顾性分析。 MDCT 上 CBD 结石的衰减模式被分类为严重钙化、不透射线、不透射线或不可检测。评估了 MDCT 上 CBD 结石的衰减模式与由纯胆固醇、混合胆固醇、棕色色素和黑色素组成的结石类型之间的关联，以及与 MDCT 检测 CBD 结石的可检测性相关的因素。 结果：在 130 名患者中，111 名患者通过 ERCP 证实了 CBD 结石，MDCT 显示出 CBD 结石，敏感性为 85.4%。 MDCT 上 CBD 结石的衰减模式为严重钙化 34 (26%)、不透射线 31 (24%)、不透射线 46 (35%) 和不可检测 19 (15%)。 CBD 结石的射线不透性根据结石类型存在显着差异 (P < 0.001)。从受试者工作特征曲线来看，结石尺寸对于通过 MDCT 确定 CBD 结石很有用（曲线下面积 0.779，P < 0.001），MDCT 上适当的截止结石尺寸为 5 mm。多变量分析显示，与 MDCT 上 CBD 结石检出率相关的因素为年龄、结石类型和结石大小（P < 0.05）。结论：MDCT 上 CBD 结石的射线不透性因结石类型而异。结石类型和结石尺寸与MDCT的可检出率相关，适宜的截断结石尺寸为5mm。 (C)2013年百事登。版权所有。
AIM: To investigate the attenuation patterns and detectability of common bile duct (CBD) stones by multidetector computed tomography (MDCT).METHODS: Between March 2010 and February 2012, 191 patients with suspicion of CBD stones undergoing both MDCT and endoscopic retrograde cholangiopancreatography (ERCP) were enrolled and reviewed retrospectively. The attenuation patterns of CBD stones on MDCT were classified as heavily calcified, radiopaque, less radiopaque, or undetectable. The association between the attenuation patterns of CBD stones on MDCT and stone type consisting of pure cholesterol, mixed cholesterol, brown pigment, and black pigment and the factors related to the detectability of CBD stones by MDCT were evaluated.RESULTS: MDCT showed CBD stones in 111 of 130 patients in whom the CBD stones were demonstrated by ERCP with 85.4% sensitivity. The attenuation patterns of CBD stones on MDCT were heavily calcified 34 (26%), radiopaque 31 (24%), less radiopaque 46 (35%), and undetectable 19 (15%). The radiopacity of CBD stones differed significantly according to stone type (P < 0.001). From the receiver operating characteristic curve, stone size was useful for the determination of CBD stone by MDCT (area under curve 0.779, P < 0.001) and appropriate cut-off stone size on MDCT was 5 mm. The factors related to detectability of CBD stones on MDCT were age, stone type, and stone size on multivariate analysis (P < 0.05).CONCLUSION: The radiopacity of CBD stones on MDCT differed according to stone type. Stone type and stone size were related to the detectability by MDCT, and appropriate cut-off stone size was 5 mm. (C) 2013 Baishideng. All rights reserved.