Radiology, Vol 154, 763-768, Copyright © 1985 by Radiological Society of North America
The bile ducts after a fatty meal: further sonographic observations
JF Simeone, RJ Butch, PR Mueller, E vanSonnenberg, JT Ferrucci Jr, DA Hall, DB Kopans, SL Dawson, J Wittenberg and K McCarthy
The sonographic appearance of the response of the common hepatic duct to
physiologic stimulation by a fatty meal was assessed in 131 patients
referred because of right upper quadrant symptoms or abnormal liver
chemical studies. In the determination of the presence or absence of
biliary obstruction, the sensitivity of the examination was 84%, the
accuracy of a positive test was 84%, and the accuracy of a negative test
was 93%. This test proved helpful in several circumstances: equivocal duct
caliber (6-10 mm); abnormal caliber (6-14 mm) with normal laboratory
values; normal caliber duct with abnormal laboratory values; persistent
question of cholelithiasis or asymptomatic pancreatic duct dilatation.
Measurements of bile duct caliber alone may be insufficient to ascertain
the presence of bile duct obstruction and fatty meal stimulation
significantly improves diagnostic accuracy.
