Abstract
Radiolucent gallstones frequently contain significant calcium deposits. Their detection is important in the evaluation of patients for medical gallstone dissolution treatment. The sensitivity and specificity of computerized tomography (CT) in detecting calcium was studied in 20 patients with radiolucent and in 3 with radiopaque gallstones. Although the sensitivity of the CT scan was somewhat higher than that of conventional radiography — 46% versus 23%, respectively, for a calcium content of at least 4% — the CT scan was negative in 4 out of 6 patients in whom the percentage of calcium in the gallstones ranged between 10 and 100. The CT scan was specific: there were no false positive results. The results of the CT scan were not related to the amount or type of calcium salt present. The study shows that the presently used CT scan of the gallbladder is not sensitive enough to select gallstone patients for medical dissolution treatment.
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Danziger RG, Hofmann AF, Schoenfield LJ, Thistle JL: Dissolution of cholesterol gallstones by chenodeoxycholic acid.N Engl J Med 286:1–8, 1972
Bell GD, Whitney B, Dowling RH: Gallstone dissolution in man using chenodeoxycholic acid.Lancet 2:1213–1216, 1972
Fromm H, Eschler A, Tollner D, Canzler H, Schmidt FW: In vivo dissolving of gallstones: the effect of chenodeoxycholic acid.Dtsch Med Wochenschr 100:1619–1624, 1975
Coyne MJ, Bonorris GG, Chung A, Goldstein LI, Lahana D, Schoenfield LJ: Treatment of gallstones with chenodeoxycholic acid and phenobarbital.N Engl J Med 292:604–607, 1975
Fromm H, Erbler HC, Eschler A, Schmidt FW: Alterations of bile acid metabolism during treatment with chenodeoxycholic acid. Studies of the role of the appearance of ursodeoxycholic acid in the dissolution of gallstones.Klin Wochenschr 54:1125–1131, 1976
Barbara L, Roda E, Roda A, Sama C, Festi D, Mazzella G, Aldini R: The medical treatment of cholesterol gallstones: experience with chenodeoxycholic acid.Digestion 14:209–219, 1976
Nakagawa S, Makino I, Ishizaki T, Dohi I: Dissolution of cholesterol gallstones by ursodeoxycholic acid.Lancet 1:367–369, 1977
Fromm H: Ursodeoxycholic acid for gallstone dissolution: the emergence of a new therapeutic application for an old bile acid. In MM Fisher CA Goresky EA Shaffer SM Strasberg (eds):Gallstones pp 363–370. Plenum Press, New York, 1979
Bell GD, Dowling RH, Whitney B, Sutor DJ: The value of radiology in predicting gallstone type when selecting patients for medical treatment.Gut 16:359–364, 1975
Trotman BW, Patella EJ, Soloway RD, Sanchez HM, Morris TA, Miller WT: Evaluations of radiographic lucency or opaqueness of gallstones as a means of identifying cholesterol or pigment stones.Gastroenterology 68:1564–1566, 1975
Korobkin M, Goldburg H: Computerized tomography of the abdomen. In MH Sleisenger JS Fordtran (eds):Gastrointestinal Disease, Pathophysiology, Diagnosis, Management p 1351. W.B. Saunders Co., Philadelphia, 1978
Trotman B, Morris TA, Sanchez H, Soloway RD, Ostrow JD: Pigment versus cholesterol cholelithiasis: identification and quantification by infrared spectroscopy.Gastroenterology 72:495–498, 1977
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Sarva, R.P., Farivar, S., Fromm, H. et al. Study of the sensitivity and specificity of computerized tomography in the detection of calcified gallstones which appear radiolucent by conventional roentgenography. Gastrointest Radiol 6, 165–167 (1981). https://doi.org/10.1007/BF01890243
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DOI: https://doi.org/10.1007/BF01890243