Медицинская литература. Новинки

 

 

 

 

 

 

Клинические и экономические аспекты лучевой диагностики механической желтухи

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Clinical and Economic Aspects of Diagnostic Imaging of an Obstructive Jaundice

To study the utilities of methods of the diagnostic visualization in diagnostics of diseases, accompanied by obstructive jaundice, we analyzed findings of examinations, performed in 111 patients. Ultrasonography was performed to all of the patients; spiral CT with an obligatory contrast enhancement was performed to 38 patients, MR cholangiography – in 21 patients, and endoscopic retrograde cholangiopancreatography (ERCP) – to 89 patients. The production costs on each method of the visualization were calculated. The analysis testified that any examination should be started with ultrasonography. Taking into account the economic and diagnostic part of any examination, aimed to reveal choledocholithiasis, the quest should be started with ultrasonography and completed with MR cholangiography when ultrasonography is negative. For diagnostics of malignant tumors the most informative method appeared to be spiral CT with contrast enhancement. A combination of CT and MR cholangiography is good for diagnostics of benign compression of a common bile duct. ERCP should be performed at final stage of the diagnostic process with a purpose of low invasive interventions to be performed and a passability of a choledochus to be restored. The sequence of the diagnostic procedures should be defined by results of the previous examination.

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