陳 敏華², 丁子 清¹, 佐藤 幸彦¹, 小笠原 和宏¹, 岸本 理和¹, 久保 公三¹, 清水 匡¹, 藤田 信行¹, 入江 五朗¹

Minhua CHEN², Kiyosi CHOIJI¹, Yukihiko SATO¹, Kazuhiro OGASAWARA¹, Riwa KISHIMOTO¹, Kozo KUBO¹, Tadashi SHIMIZU¹, Nobuyuki FUJITA¹, Goro IRIE¹

¹北海道大学医学部放射線医学教室, ²北京医科大学腫瘤研究所

¹Department of Clinical Radiology, Hokkaido University School of Medicine, ²

キーワード : Ultrasonography, Bile duct, Dilatation of bile duct, Cholagogue

Ultrasonography (US) with additional methods consisted of abdominal pressure method (ACM) and cholagogue method (CM) was applied to those cases devided into three groups: 27 cases with stenosis or obstruction in the extrahepatic bile duct (EHBD) stenotic group; 37 cases without stenosis or obstruction in EHBD non-stenotic group; 37 cases of normal volunteer control group. All the cases belonging to stenotic or non-stenotic group had slightly dilated EHBD which diameter ranged from 7 to 18 mm. While decrease in EHBD diameter after ACM occurred in 72% (26⁄36 cases) of non-stenotic group, diameter of EHBD in 50% (13⁄26) of stenotic group showed increase and in 19% (5⁄26) showed no change. Control groups after ACM, having smaller diameter of EHBD in comparison with that of cases belonging to other two groups, showed no change in 70% (26⁄37) and decrease in 27% (10⁄37). After CM, stenotic group showed increase or no change in diameter of EHBD in 73% (11⁄15), while non-stenotic group showed decrease in 94% (15⁄16); a half of control group showed decrease and the other half showed no change. The Chi-square test proved significant association between the groups and the change in EHBD diameter after ACM as well as after CM (both p<0.001). This study also revealed that EHBD of the cases underwent cholecystectomy well, reacting the additional methods decrease in diameter of EHBD was observed in about 90% after ACM as well as after CM. A criteria, judging a cases without decrease in EHBD diameter after each of the additional method as having stenosis in EHBD, yielded sensitivities of 69% after ACM and of 73% after CM; specificities of 72% after ACM and of 94% after CM; accuracies of 71% after ACM and 84% after CM. The US with additional methods, which are performed easily and with little pain or effort of the patient, are useful in screening of stenotic lesion at EHBD in those cases having slightly dilated EHBD.