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Diagnostic accuracy of ultrasonography in adults with obstructive jaundice

Olufunke O. Fadahunsi
Olufunke O. Fadahunsi
, 
Bolanle O. Ibitoye
Bolanle O. Ibitoye
, 
Adewale O. Adisa
Adewale O. Adisa
, 
Olusegun I. Alatise
Olusegun I. Alatise
, 
Victor A. Adetiloye
Victor A. Adetiloye
 oraz 
Bukunmi Michael Idowu
Bukunmi Michael Idowu
   | 15 cze 2020
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Article Category: research-article
Data publikacji: 15 cze 2020
Zakres stron: 100 - 105
Otrzymano: 16 lut 2020
Przyjęty: 23 kwi 2020
DOI: https://doi.org/10.15557/jou.2020.0016
Słowa kluczowe
© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

Longitudinal sonogram of the gallbladder showing gallstone disease in 2 patients as A. an impacted echogenic structure in the gallbladder neck (arrowhead) with acoustic shadowing (star), and B. multiple echogenic structures within a contracted gallbladder giving a wall-echo shadow complex (downward arrows)
Longitudinal sonogram of the gallbladder showing gallstone disease in 2 patients as A. an impacted echogenic structure in the gallbladder neck (arrowhead) with acoustic shadowing (star), and B. multiple echogenic structures within a contracted gallbladder giving a wall-echo shadow complex (downward arrows)

Fig. 2.

Choledocholithiasis – longitudinal sonogram of the hepatic hilum showing a large calculus with posterior acoustic shadow (star) within dilated common bile duct (downward arrow); the gallbladder (arrowheads) and portal vein (upward arrow) are also shown
Choledocholithiasis – longitudinal sonogram of the hepatic hilum showing a large calculus with posterior acoustic shadow (star) within dilated common bile duct (downward arrow); the gallbladder (arrowheads) and portal vein (upward arrow) are also shown

Fig. 3.

Transverse sonogram of the pancreas showing a manifestation of pancreatic carcinoma as an enlarged, lobulated and hypoechoic pancreatic head (curved and double arrows)
Transverse sonogram of the pancreas showing a manifestation of pancreatic carcinoma as an enlarged, lobulated and hypoechoic pancreatic head (curved and double arrows)

Comparison of Ultrasound Diagnosis with Final Diagnosis (Surgical/Histological)

Ultrasound diagnosis Accuracy (%) PPV (%) NPV (%) Sensitivity (%) Specificity (%)
Pancreatic carcinoma 90.9 85.0 92.0 81.0 94.6
Choledocholithiasis 88.8 75.0 92.0 70.7 93.7
Liver cirrhosis 94.9 50.0 97.0 50.0 97.0
Hepatocellular carcinoma 100.0 100.0 100.0 100.0 100.0
Gastric carcinoma 98.8 100.0 98.7 50.0 100.0
Gall bladder carcinoma 94.0 92.0 95.0 80.0 98.0
Cholangitis 97.5 0.0 97.5 0.0 100.0
Cholangiocarcinoma 100.0 100.0 100.0 100.0 100.0
Periampullary carcinoma 96.3 62.5 100.0 100.0 96.0
Lymphoproliferative disease 98.8 50.0 100.0 100.0 99.0
Metastatic disease 98.8 100.0 99.0 80.0 100.0

Prevalence of dilatation of biliary ducts with level of obstruction

a) Prevalence of dilatation of biliary ducts with mean diameters
Biliary duct Number of patients N (%) Diameter of the duct (mm)
Mean ± SD Median Range
CBD 60 (75.0) 13.7 ± 7.3 13.9 3.0–32.0
CHD 15 (18.7) 12.8 ± 4.8 12.0 4.5–28.0
No dilatation 5 (6.3) - - -
Total 80 (100.0) - - -
b) Comparison of degree of biliary dilatation with level of obstruction
Mean biliary dilatation Intrapancreatic obstruction Suprapancreatic obstruction Hilar obstruction p -value *
CBD Diameter (Mean ± SD mm) 19.4 ± 5.3 9.8 ± 4.2 6.4 ± 1.9 <0.001
CHD Diameter (Mean ± SD mm) 15.2 ± 5.2 11.6 ± 2.9 10.7 ± 2.1 <0.001

Ultrasound diagnosis of obstructive jaundice

Ultrasound Diagnosis Number of patients Percentage (%)
Pancreatic carcinoma 23 28.8
Choledocholithiasis 15 18.7
Gallbladder carcinoma 13 16.3
Periampullary carcinoma 8 10.0
Cholangiocarcinoma 4 5.0
Metastatic lesion 4 5.0
Choledocholithiasis + Cirrhosis 3 3.7
Cholelithiasis 3 3.8
Cholecystitis 2 2.5
Lymphoproliferative disease 2 2.5
Gastric carcinoma 1 1.2
Hepatocellular carcinoma 1 1.3
Liver cirrhosis 1 1.2
Total 80 100

Age and sex of patients with obstructive jaundice

Age (years) Sex
Frequency (%)
Male Female Total
16–19 2 (2.50) 1 (1.25) 3 (3.75)
20–29 2 (2.50) 5 (6.25) 7 (8.75)
30–39 1 (1.25) 6 (7.50) 7 (8.75)
40–49 4 (5.00) 8 (10.00) 12 (15.00)
50–59 8 (10.00) 15 (18.75) 23 (28.75)
60–69 11 (13.75) 11 (13.75) 22 (27.50)
70–79 0 (0.00) 4 (5.00) 4 (5.00)
80–89 0 (0.00) 2 (2.50) 2 (2.50)
Total 28 (35) 52 (65) 80 (100)
eISSN:
2451-070X
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medicine, Basic Medical Science, other
Kanał RSS czasopisma