经十二指肠EUS确定原发性硬化性胆管炎中肝外胆管树管壁增厚  

Duodenal EUS to identify thickening of the extrahepatic biliary tree wall in primary sclerosing cholangitis

作　　者：Mesenas S. Vu C. Doig L. Meenan J. 陈瑜(译) 郑世成(校) 

机构地区：[1]不详 [2]Department of Gastroenterology, College House, St. Thomas' Hospital, London SE1 7EH, United Kingdom

出　　处：《世界核心医学期刊文摘（胃肠病学分册）》2006年第8期27-28,共2页Core Journals in Gastroenterology

摘　　要：Background: Diagnosing primary sclerosing cholangitis (PSC) is problematic and requires meeting a burden of proof through clinical, biochemical, radiologic, and histological features. Endoscopic ultrasound yields detailed images of the extrahepatic biliary tree, but its value in contributing to the diagnosis of this condition is unknown. Objectives: To determine the potential for transduodenal EUS to detect common bile duct wall thickening in PSC.Design: A prospective, controlled study with retrospective, blinded data analysis. Setting: Single tertiary referral center for inflammatory bowel disease and EUS. Patients: Four groups of patients were assessed with radial endosonography: PSC (n = 9); inflammatory bowel disease (IBD) with abnormal liver blood tests (n = 21); choledocholithiasis (n = 15); and normal controls (n = 50). Measurements were made of the common bile duct diameter and wall thickness. Interventions: Transduodenal radial EUS of the biliary tree. Main Outcome Measurements: Common bile duct diameter and wall thickness. Results: The mean diameter (SD) of the common bile duct for the PSC, IBD, choledocholithiasis, and normal control groups measured 8.9 mm (2.8), 5.4 mm (1.7), 7.2 mm (2.2), and 5.0 mm (1.9), respectively (PSC and chole-docholithiasis groups compared to the IBD group, P < .05 for a single test of hypothesis, but correction for the multiple testing of data removed this significance; normal control group P < .005). Mean ductal wall thickness (SD) was 2.5 mm (0.8) for the PSC group, 0.7 mm (0.4) for the IBD group, 0.8 mm (0.4) for the choledocholithiasis group, and 0.8 mm (0.4) for the normal control group, respectively (PSC group compared to the other 3 groups, P < .005). Limitations: Assessment of intrahepatic PSC is problematic. Conclusion: Thickening ( >1.5 mm) of the common bile duct wall is seen in patients with PSC but not in those with aPPArently uncomplicated IBD or choledocholithiasis. The results of this study suggest that standard endosonography contributes to the imaging and pBackground： Diagnosing primary sclerosing cholangitis （PSC） is problematic and requires meeting a burden of proof through clinical, biochemical, radiologic, and histological features. Endoscopic ultrasound yields detailed images of the extrahepatic biliary tree, but its value in contributing to the diagnosis of this condition is unknown. Objectives： To determine the potential for transduodenal EUS to detect common bile duct wall thickening in PSC. Design： A prospective, controlled study with retrospective, blinded data analysis. Setting： Single tertiary referral center for inflammatory bowel disease and EUS. Patients： Four groups of patients were assessed with radial endosonography： PSC （n = 9）; inflammatory bowel disease （IBD） with abnormal liver blood tests （n = 21）; choledocholithiasis （n = 15）; and normal controls （n = 50）. Measurements were made of the common bile duct diameter and wall thickness. Interventions： Transduodenal radial EUS of the biliary tree. Main Outcome Measurements： Common bile duct diameter and wall thickness. Results： The mean diameter （SD） of the common bile duct for the PSC, IBD, choledocholithiasis, and normal control groups measured 8.9 mm （2.8）, 5.4mm （1.7）, 7.2mm （2. 2）, and 5.0 mm （1.9）, respectively （PSC and choledoeholithiasis groups compared to the IBD group, P 〈 . 05 for a single test of hypothesis, but correction for the multiple testing of data removed this significance; normal control group P 〈. 005 ）. Mean ductal wall thickness （SD） was 2. 5 mm （0. 8） for the PSC group, 0.7 mm （0. 4） for the IBD group, 0. 8 mm （0. 4） for the choledocholithiasis group, and 0. 8 mm （0. 4） for the normal control group, respectively （PSC group compared to the other 3 groups, P 〈. 005 ）. Limitations： Assessment of intrahepatic PSC is problematic.

关 键 词：超声内镜(EUS) 原发性硬化性胆管炎 经十二指肠 胆总管壁 胆管树 增厚 肝外 胆总管直径 影像学检查 管壁厚度 

分 类 号：R445[医药卫生—影像医学与核医学] R657.45[医药卫生—诊断学]