Comparison of real-time cholecystosonography and oral cholecystography.

To evaluate the efficacy of real-time ultrasonography in detecting cholelithiasis, a series of outpatients and inpatients was examined by oral cholecystography and real-time cholecystosonography. In 163 patients, real-time cholecystosonography achieved a sensitivity of 0.91 and a specificity of 0.99. These values are equal to or better than those usually obtained in current B-mode cholecystosonography or some reported series of oral cholecystography. However, technically excellent and meticulously performed oral cholecystography achieves slightly better sensitivity and specificity than real-time cholecystosonography. The latter is suggested as the initial examination for hospitalized patients, those with abnormal liver function studies or gastric outlet obstruction, and pregnant women. Real-time ultrasonography should also be used when the gallbladder is not adequately opacified on initial oral cholecystography if a sequential dose examination cannot be readily accomplished.