Department of Radiology, College of Medicine, Chungang University
ABSTRACT
To evaluate the microstructure and sonographic charateristics of intrahepatic stones that may vary accordingto the types of stones, intrahepatic stones from 32 patients were examined by scanning electron microscope(SEM)and in vitro sonography. The types of stones were determined by gross characteristics on cross section(laminatedversus amorphous) and chemical composition. The sonographic patterns were classified into type 1(definable echoesfrom the whole stone with gradual attenuation) and type 2(arc-like strong echo from the surface of the stone withclear acoustic shadow). Cholesrol stones(mixed stone, n=2) showed randomly oriented cholesterol crystals in itsinner matrix at SEM and sonographic type 1. Calcium bilirubinate stones with amorphous structure(n=18) showedrandomly located calcium palmitate rosetters and cholesterol crystals within the matrix. In calcium bilirubinatestones with laminated structure(n=12) the layer of calcium palmitate rosette could be identified at SEM. Fourteenand 11 calcium bilirubinate stones showed type 1 and type 2 sonographic patterns, respectively. Five stones werebroken and missing during sonography. There was no significant difference in sonographic patterns between thecalcium bilirubinate stones with laminate structure and those with amorphous structure. In conclusion,intrahepatic stones showed characteristic SEM findings according to the type of stones. Hower, any sonographicpatterns that might characterize the microstructure and chemical composition of the stones could not be found inthis in vitro sonographic study.
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