significance of ultrasound in diagnosing gallstone disease

ABSTRACT

The efficacy and sensitivity of transabdominal ultrasonography [TUS] for detecting gallstones in patients with biliary colic and biliary tract diseases was studied. A prospective study was carried out between February 2003 and February 2007, in the Surgical Department of Al-Gamhouria Teaching Hospital. Patients with Ultrasound diagnosis of gallbladder [GB] and common bile duct [CBD] stones diseases [including 2 cases with biliary colic like pain and negative TUS result] were admitted to the hospital for cholecystectomy and, in indicated cases for choledochotomy. Presence or absence of stones were noted. CT-scanning was ordered in patients with obstructive jaundice. The computer program Quickcalcs of Graphpad software was applied for data processing [http/graphpad.com/quickcalcs]. TUS was performed on 114 consecutive patients; 103 [90.35%] were women and 11 [9.65%] were men. The ages ranged between 20 to 80 years, with mean age of 43.62 years. For gallbladder stones; there were 108 True Positive, 2 True Negative, 3 False Positive and one False Negative scans, yielding 94.74% sensitivity, 66.67% specificity, and 96.49% accuracy. Positive Predictive Value [PPV] for gallbladder stones was 16.66% and Negative Predictive Value [NPV] was 97.22%. Nine patients out of 114 [7.9%] had associated with common bile duct obstruction, 6 women [5.26%] and 3 men [2.63%], with 7 True Positive, one False Positive, and one False Negative results for choledocholithiasis, yielding 77.78% sensitivity, 92.11% specificity, and 98.25% accuracy. PPV was 45.78%, whereas NPV was 97.98%. The Ultrasound provided an effective and reliable means for the diagnosis of GB and CBD stone diseases