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Prospective, multicenter study on value of computerized tomography (CT) in gallstone disease in predicting response to bile acid therapy.

Abstract：

:The aim of the study was to assess the value of quantitative attenuation values (Hounsfield units) and of gallstone pattern by computerized tomography in predicting response to bile acid therapy. We carried out a prospective study in a multicenter setting on 90 consecutive outpatients with radiolucent gallstones. All received bile acid therapy (UDCA 10 mg/kg/day or UDCA + CDCA 5 mg/kg/day of each) up to two years. Hounsfield units for gallstones were recorded using standardized criteria and six categories of patterns were defined: hypodense, isodense, homogenously dense, laminated, rimmed and speckled. We assessed gallstone dissolution rate (percent reduction in volume), response to therapy (> 25% reduction in volume), and final outcome of therapy. Eighty-one percent of patients with hypodense/isodense and all four patients with speckled stone pattern responded to therapy, whereas none of the 10 patients with laminated/rimmed and only 45% of patients with homogenously dense stone pattern did. Complete dissolution was achieved by 68%, 50%, 35%, 0% of the hypodense/isodense, speckled, homogenously dense, rimmed/laminated gallstones, respectively. The use of Hounsfield units did not show an advantage over gallstone pattern for predicting either response or final outcome to bile acid therapy. We conclude that computerized tomography analysis of gallstones is of value in predicting response to bile acid therapy and that gallstone pattern alone predicts response in most cases without the need for quantitative assessment.

journal_name

Dig Dis Sci

journal_title

Digestive diseases and sciences

authors

Petroni ML,Jazrawi RP,Grundy A,Lanzini A,Pigozzi MG,Biasio A,Heaton KW,Virjee J,Northfield TC

doi

10.1007/BF02208664

subject

Has Abstract

pub_date

1995-09-01 00:00:00

pages

1956-62

issue

9

eissn

0163-2116

issn

1573-2568

journal_volume

40

pub_type

临床试验,杂志文章,多中心研究

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