线阵超声内镜对胆总管结石的诊断价值研究  

Value of linear array endoscopic ultrasonography in the diagnosis of common bile duct stones

作　　者：李银鹏[1] 朱惠明[1] 黄勋[1] 姜岭梅[1] 罗伟香[1] 陆洁贞[1] 

机构地区：[1]暨南大学医学院第二附属医院消化内科,深圳518020

出　　处：《临床超声医学杂志》2005年第6期379-381,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨线阵超声内镜对胆总管结石的诊断价值。方法对35例腹部B超发现胆总管扩张,临床怀疑胆总管结石的患者行线阵超声内镜检查,并在3 d内再行ERCP及乳头扩约肌切开胆总管取石,以取石的结果计算线阵超声内镜诊断的准确率、灵敏度、特异度、阳性预测值、阴性预测值及Youden指数。结果35例患者中,经线阵超声内镜检查及胆总管取石结石均阳性者22例,阳性率为62.8%(22/35),均阴性者12例。线阵超声内镜检查有1例假阳性,无假阴性。与胆总管取石比较,线阵超声内镜诊断胆总管结石的准确率为97.1%,灵敏度为100%,特异度为92.3%,阳性预测值为95.6%,阴性预测值100%,Youden指数为92.3%,且未出现并发症。结论线阵超声内镜检查是诊断胆总管结石安全而可靠的方法。Objective To investigate the value of hnear array endoscopic ultrasonography （EUS） in the diagnosis of common bile duct（CBD） stones. Methods 35 patients with enlarged CBD on transabdominal ultrasonography and clinic suspicion of CBD stones were examined by linear array EUS at first, then followed by endoscopic retrograde cholangiopancreatography（ERCP） with endoscopic sphincterotomy（EST） and exploration of CBD within 3 days. The results of extraction of CBD stones was used as diagnostic “gold standards”. The diagnostic value of linear array EUS was assessed by calculate the accuracy, sensitivity, specificity, positive predictive val- ue, negative predictive value and Youden index. Results In 35 cases, both hnear array EUS and exploration of CBD after EST were positive in 22 patients（62.8% ,22/35） and negative in 12 patients. There was one false- positive on linear array EUS, without false- negative. Compard with extraction of CBD after EST, the accuracy, specificity, sensitivity, positive predictive value, negative predictive value and Youden index of linear array EUS was 97.1%, 100%, 92.3%, 95.6%, 100% and 92.3% respectively and without complication complication. Conclusion linear array EUS is a safe and reliable method for diagnosis of CBD stones.

关 键 词：内镜超声检查 胆总管结石 乳头扩约肌 线阵超声内镜 

分 类 号：R575.7[医药卫生—消化系统] R657.42[医药卫生—内科学]