CT-Profile analysis of gallbladder stones

Qualitative diagnosis of gallbladder stones was attempted in 149 cases on the basis of the pattern and CT values of individual stones assessed along cross-sectional lines passing from the center of the stones to their maximum diameters (CT-Profiles). Macroscopic views of cutsurfaces of the stones we...

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Published inTando Vol. 9; no. 4; pp. 289 - 297
Main Authors OKAYAMA, Yasutaka, IIDA, Masayuki, GOTO, Kazuo, HOSHINO, Makoto
Format Journal Article
LanguageJapanese
Published Japan Biliary Association 1995
Subjects
CT-Profile曲線
胆石の肉眼分類
胆石の質的診断
Online AccessGet full text
ISSN0914-0077
1883-6879
DOI10.11210/tando1987.9.4_289

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Abstract Qualitative diagnosis of gallbladder stones was attempted in 149 cases on the basis of the pattern and CT values of individual stones assessed along cross-sectional lines passing from the center of the stones to their maximum diameters (CT-Profiles). Macroscopic views of cutsurfaces of the stones were classified according to the guidelines of the Japanese Society of Gastroenterology. CT-Profiles were classified into six types. Correspondence between macroscopic findings and CTProfiles of each type of stones could be obtained as follows: pure cholesterol stones,29/33 (88%); combination stones,16/21 (76%); mixed stones,32/34 (94%); black stones,22/43 (51%) and calcium bilirubinate stones,13/18 (72%). Cholesterol stones were diagnosed excellently by CTProfiles, but pigment stones were not so good. Finally, correct diagnosis was gained in 75% of patients.
AbstractList Qualitative diagnosis of gallbladder stones was attempted in 149 cases on the basis of the pattern and CT values of individual stones assessed along cross-sectional lines passing from the center of the stones to their maximum diameters (CT-Profiles). Macroscopic views of cutsurfaces of the stones were classified according to the guidelines of the Japanese Society of Gastroenterology. CT-Profiles were classified into six types. Correspondence between macroscopic findings and CTProfiles of each type of stones could be obtained as follows: pure cholesterol stones,29/33 (88%); combination stones,16/21 (76%); mixed stones,32/34 (94%); black stones,22/43 (51%) and calcium bilirubinate stones,13/18 (72%). Cholesterol stones were diagnosed excellently by CTProfiles, but pigment stones were not so good. Finally, correct diagnosis was gained in 75% of patients. CTによる胆石の質的診断を目的とし, 149症例の術前CTを検討した. 方法は胆石の最大割面が得られるCT画像上で, 胆石の中心線上のCT値変化を曲線として表示(CT-Profile曲線)し, その曲線形状と日本消化器病学会胆石症検討委員会による肉眼分類を対比することにより行なった. CT-Profile曲線は, 曲線形状とCT値の検討より6型に分類された (CT-Profile分類). さらに, 胆石数を4個以下と5個以上の2群に分け, 肉眼分類との対比を行なうことにより各胆石の診断率を算出した. CT-Profile分類における診断率は, コレステロール胆石では純コレステロール石88%, 混成石76%, 混合石94%であり, 極めて高い診断率を有したが, それに比較して色素胆石では, 黒色石51%, ビリルビンカルシウム石72%とやや劣っていた. また, 胆石全体の診断率は75%であった.
Qualitative diagnosis of gallbladder stones was attempted in 149 cases on the basis of the pattern and CT values of individual stones assessed along cross-sectional lines passing from the center of the stones to their maximum diameters (CT-Profiles). Macroscopic views of cutsurfaces of the stones were classified according to the guidelines of the Japanese Society of Gastroenterology. CT-Profiles were classified into six types. Correspondence between macroscopic findings and CTProfiles of each type of stones could be obtained as follows: pure cholesterol stones,29/33 (88%); combination stones,16/21 (76%); mixed stones,32/34 (94%); black stones,22/43 (51%) and calcium bilirubinate stones,13/18 (72%). Cholesterol stones were diagnosed excellently by CTProfiles, but pigment stones were not so good. Finally, correct diagnosis was gained in 75% of patients.
Author IIDA, Masayuki
OKAYAMA, Yasutaka
HOSHINO, Makoto
GOTO, Kazuo
Author_FL 後藤 和夫
岡山 安孝
飯田 昌幸
星野 信
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  fullname: GOTO, Kazuo
  organization: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital
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  fullname: HOSHINO, Makoto
  organization: First Department of Internal Medicine, Nagoya City University Medical School
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References 10) Rambow A, Staritz M, Wosiewitz U, et al: Analysis of radiolucent gallstones by computed tomography for in vivo estimation of stone components. Eur J Clin Invest 20: 475-478, 1990
3) Trotman BW, Petrella EJ, Soloway RD, et al: Evaluation of radiographic lucency or opaqueness of gallstones as a means of identifying c holesterol or pigment stones. Gastroenterology 68: 1563-1566, 1975
14) 飯田昌幸, 岡山安孝, 後藤和夫ほか: 胆石の肉眼分類と成分分析法, 日本臨牀 51: 1718-1724, 1993
5) Dolgin SM, Schwartz JS, Kressel HY, et al: Identification of patients with cholesterol or pigment gallstones by discriminant analysis of radiog raphic features. N Engl J Med 304: 808-811, 1981
11) Baron RL, Rohrmann Jr CA, Lee SP, et al: CT evaluation of gallstones in vitro: correlation with chemical analysis. Am J Roentgenol 151: 1123-1128, 1988
9) Janowitz P, Zöller A, Swobodnik W, et al: Computed tomography evaluation of radiolucent gallstones in vivo. Gastrointest Radiol 15: 58-60, 1990
1) 岡山安孝, 後藤和夫, 野口良樹ほか: 総胆管結石症に対するCT-cholangiogrmphyの基礎的, 臨床的検討. 胆道 3: 18-28, 1989
12) Brakel K, Lamris JS, Nijs HGT, et al: Predicting Gallstone composition with CT: in vivo and vitro analysis. Radiology 174: 337-341, 1990
13) 伊佐治秀司, 野口 孝, 水本龍二: 胆石症の診断におけるCT scanの意義-特に結石の組成とCT値について-, 日消誌 79: 1757-1765, 1982
4) 高木一郎, 柴本由香, 日原雅文ほか: 特集胆石の分類とその診断上の問題点腹部単純X線撮影. 胆と膵 12: 1185-1190, 1991
2) 山形敞一, 槇哲夫, 大菅俊明ほか: 日本における胆石の新しい分類(日本消化器病学会胆石症検討委員会), 日消誌 83: 309-316, 1986
7) 矢沢孝文, 土屋幸浩, 税所宏光ほか: 胆石の超音波特性に基づく性状診断. 日消誌 85: 708-714, 1988
8) 林 仁守, 太田恵輔, 小笠原鉄郎ほか: 特集急性胆嚢炎と胆石症の画像診断 胆石症の超音波診断. 画像診断 10: 680-687, 1990
6) 北山 修, 伊勢秀雄, 阿部 裕ほか: 特集胆石の分類とその診断上の問題点DICからみた胆石種類の診断. 胆と膵 12: 1191-1197, 1991
References_xml – reference: 11) Baron RL, Rohrmann Jr CA, Lee SP, et al: CT evaluation of gallstones in vitro: correlation with chemical analysis. Am J Roentgenol 151: 1123-1128, 1988
– reference: 3) Trotman BW, Petrella EJ, Soloway RD, et al: Evaluation of radiographic lucency or opaqueness of gallstones as a means of identifying c holesterol or pigment stones. Gastroenterology 68: 1563-1566, 1975
– reference: 4) 高木一郎, 柴本由香, 日原雅文ほか: 特集胆石の分類とその診断上の問題点腹部単純X線撮影. 胆と膵 12: 1185-1190, 1991
– reference: 7) 矢沢孝文, 土屋幸浩, 税所宏光ほか: 胆石の超音波特性に基づく性状診断. 日消誌 85: 708-714, 1988
– reference: 1) 岡山安孝, 後藤和夫, 野口良樹ほか: 総胆管結石症に対するCT-cholangiogrmphyの基礎的, 臨床的検討. 胆道 3: 18-28, 1989
– reference: 9) Janowitz P, Zöller A, Swobodnik W, et al: Computed tomography evaluation of radiolucent gallstones in vivo. Gastrointest Radiol 15: 58-60, 1990
– reference: 2) 山形敞一, 槇哲夫, 大菅俊明ほか: 日本における胆石の新しい分類(日本消化器病学会胆石症検討委員会), 日消誌 83: 309-316, 1986
– reference: 12) Brakel K, Lamris JS, Nijs HGT, et al: Predicting Gallstone composition with CT: in vivo and vitro analysis. Radiology 174: 337-341, 1990
– reference: 14) 飯田昌幸, 岡山安孝, 後藤和夫ほか: 胆石の肉眼分類と成分分析法, 日本臨牀 51: 1718-1724, 1993
– reference: 6) 北山 修, 伊勢秀雄, 阿部 裕ほか: 特集胆石の分類とその診断上の問題点DICからみた胆石種類の診断. 胆と膵 12: 1191-1197, 1991
– reference: 8) 林 仁守, 太田恵輔, 小笠原鉄郎ほか: 特集急性胆嚢炎と胆石症の画像診断 胆石症の超音波診断. 画像診断 10: 680-687, 1990
– reference: 10) Rambow A, Staritz M, Wosiewitz U, et al: Analysis of radiolucent gallstones by computed tomography for in vivo estimation of stone components. Eur J Clin Invest 20: 475-478, 1990
– reference: 5) Dolgin SM, Schwartz JS, Kressel HY, et al: Identification of patients with cholesterol or pigment gallstones by discriminant analysis of radiog raphic features. N Engl J Med 304: 808-811, 1981
– reference: 13) 伊佐治秀司, 野口 孝, 水本龍二: 胆石症の診断におけるCT scanの意義-特に結石の組成とCT値について-, 日消誌 79: 1757-1765, 1982
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SubjectTerms CT-Profile曲線
胆石の肉眼分類
胆石の質的診断
Title CT-Profile analysis of gallbladder stones
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