[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Article
March 1986

Computed Tomographic Analysis of GallstonesAn In Vitro Study

Author Affiliations

From the Departments of Surgery (Drs Hickman and Schwesinger) and Radiology (Dr Bova), University of Texas Health Science Center at San Antonio and Audie Murphy Memorial Veterans Hospital, and the Department of Chemistry, Trinity University (Dr Kurtin), San Antonio, Tex.

Arch Surg. 1986;121(3):289-291. doi:10.1001/archsurg.1986.01400030043007
Abstract

• The chemical dissolution of gallstones cannot be accurately predicted since available biliary studies often do not distinguish stone types. To elucidate the predictive value of computed tomography (CT), 65 gallstones were studied in vitro. Thirty stones were analyzed by both CT and infrared spectroscopy. The CT number (Hounsfield unit [HU]) was significantly different for cholesterol and pigment stones (−87.3±14.5 vs 162 ±27.6 HU) and demonstrated a linear correlation with cholesterol content. Another 35 gallstones were tested for dissolution in a 200mM chenodeoxycholate solution after CT analysis. Thirteen stones (50%) with CT values less than 50 HU completely dissolved in three weeks, whereas none of the stones with CT numbers greater than 50 HU dissolved. These findings suggest that the CT analysis of gallstones allows accurate gallstone classification and is useful in predicting solubility.

(Arch Surg 1986;121:289-291)

References
1.
Bouchier I:  Gallstone dissolving agents . Br Med J 1983;286:778-780.Article
2.
Girard RM, Legros G:  Retained and recurrent bile duct stones: Surgical or nonsurgical removal? Ann Surg 1981;193:150-154.Article
3.
Kutz K, Miederer SE, Paumgartner G:  Chenodeoxycholic acid therapy of intrahepatic radiolucent gallstones in a patient with Caroli's syndrome . Hepatogastroenterology 1978;25:398-401.
4.
Schoenfield LJ, Lachin JM:  National Cooperative Gallstone Study: Chenodiol (chenodeoxycholic acid) for dissolution of gallstones: A controlled trial of efficacy and safety . Ann Intern Med 1981;95:257-281.Article
5.
Trotman BW, Ostrow JD, Soloway RD:  Pigment vs cholesterol cholelithiasis: Comparison of stone and bile composition . Dig Dis Sci 1974; 19:585-590.Article
6.
Swinscow TD: Statistics at Square One , ed 2. London, British Medical Association, 1977.
7.
Havrilla TR, Reich NE, Haaga JR:  Computed tomography of the gallbladder . AJR 1978;130:1059-1067.Article
8.
Toombs BD, Sandler CM, Conoley PM, et al:  Computed tomography of the nonvisualizing gallbladder . J Comput Assist Tomogr 1981;5:164-168.Article
9.
Parulekar SG:  Ultrasonic detection of calcification in gallstones: The reverberation shadow . J Ultrasound Med 1984;3:123-129.
10.
Sarva RP, 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 1981;6:165-167.Article
11.
Moss AA, Filly RA, Way LW:  In vitro investigation of gallstones with computed tomography . J Comput Assist Tomogr 1980;4:827-831.Article
12.
Carroll BA:  Gallstones: In vitro comparison or physical, radiographic and ultrasonic characteristics . AJR 1978;131:223-226.Article
13.
Dolgin SM, Schwartz JS, Kressel HY, et al:  Identification of patients with cholesterol or pigment stones by discriminant analysis of radiographic features . N Engl J Med 1981;304:808-811.Article
14.
Maton PN, Iser JH, Reuben A, et al:  Outcome of chenodeoxycholic acid (CDCA) treatment in 125 patients with radiolucent gallstones: Factors influencing efficacy withdrawal symptoms and side effects and postdissolution recurrence . Medicine 1982;61:86-97.Article
15.
Moon K, Kricak H, Margulis AR, et al:  Nuclear magnetic resonance imaging characteristics of gallstones in vitro . Radiology 1983;148:753-756.Article
16.
Funatsu K, Phillips MJ:  Dissolution of human cholesterol gallstones in vitro with bile salts: A scanning and stereoscanning electron microscopic study . Lab Invest 1979;40:166-171.
×