[Diagnostic value of direct and indirect cholangiography - a comparative study].
Stimulated by Goodman's paper and the discussion evoked by this we, too, compared the valency of the intravenous cholography with the evidence of the direct cholography. Among our selected patients (95 patients) in 60% we did not find an accordance of the two methods. The intravenous cholography were with Goodman' criteria judged by a radiologist at 42% as optimal, at 24% as suboptimal and at 34% without evidence. Also a control group of 50 intravenous cholographies in accidental order were to be estimated as optimal only in 56%. In 39 cases only the direct cholography could bring the definitive diagnosis, the intravenous cholographies, no doubt, were pathologically sufficient, but not for the final clarification. 16% falsely positive and 10% falsely negative judged intravenous cholographies are particularly aggravating in our study. Mainly the explanation of a dilated choledochus and changes near the papilla, the finding of the calculus in the duct system and the possibility to estimate the intrahepatic bile ducts were the weak points in the evidence of the intravenous cholography. According to our results only the direct cholography brings the exact and for therapy guiding diagnostics, particularly before reinterventions on the bile ducts with the increased risk of operation. This and the justifiably small complications vindicate the invasive diagnostics.
D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging*; D002758:Cholangiography / Q000379:methods*; D006801:Humans; D008875:Middle Aged
Die Aussagefähigkeit der direkten und indirekten Cholegraphie - eine vergleichende Untersuchung.