两种胆胰管造影方法临床应用价值的荟萃分析  

A meta-analysis of clinical efficiency of two methodologies of cholangiopancreatography

作　　者：侯婧[1] 詹俊[1] 于钟[1] 李楚强[1] 张世能[1] 梁汉霖[1] 

机构地区：[1]中山大学附属第二医院消化科,广州510120

出　　处：《中华内科杂志》2006年第11期900-903,共4页Chinese Journal of Internal Medicine

摘　　要：目的评价内镜下逆行胰胆管造影术(ERCP)和磁共振胰胆管造影术(MRCP)在具有可疑胆胰疾病患者中的应用价值。方法通过MEDLINE、EMBASE等数据库检索国内外已发表和未发表的相关文献。选择针对具有可疑胆胰疾病患者,使用ERCP和MRCP两种方法进行比较的前瞻性研究。由2位评价者分别按以上检索策略收集资料,按选择标准入选,主要对两种检查方法的敏感性和特异性进行荟萃分析。结果ERCP和MRCP诊断胆总管结石、胆胰管狭窄、胆胰系统恶性疾病的敏感性差异无统计学意义。两者对上述疾病诊断的特异性方面,仅在诊断胰胆管狭窄时,ERCP高于MRCP,OR为6.17,95%CI为1.35～20.24,P=0.02。对于总体胆胰系统疾病的诊断,ERCP的敏感性和特异性均优于MRCP,OR分别为1.72和4.05,95%CI分别为1.04～2.85和1.32～12.42,P值分别为0.04及0.01。结论在诊断胆胰系统疾病时,总体敏感性和特异性都是ERCP优于MRCP。临床医生可以根据患者耐受程度和价效分析进行对ERCP和MRCP的取舍决策。Objective To compare the efficiency of endoscopic retrograde cholangiopancreatography （ERCP） and magnetic resonance cholangiopancreatography （MRCP） in patients with suspected biliary tract or pancreatic diseases. Methods Find those prospective comparison trials about the efficiency of ERCP and MRCP in patients with suspected biliary tract or pancreatic diseases from many kinds of database, such as MEDLINE、EMBASE and so on. According to inclusion criteria, two operant choose suitable papers for this study. Collect corresponding original data and make a meta-analysis to compare the sensitivity and specificity of ERCP and MRCP in choledocholithiasis, strictures and malignant tumor. Results Finally we get 6 articles from 302 ones. To diagnose choledocholithiasis, strictures and malignant tumor, the difference of sensitive between ERCP＇s and MRCP＇s is not significant. When it comes to the specificity of ERCP and MRCP in those diseases, ERCP is better than MRCP only in strictures, OR is 6. 17 （95% CI 1.35 - 20. 24） ,P = 0. 02. However, we find ERCP is better than MRCP not only in total sensitivity but specificity of biliary tract or pancreatic diseases, OR is 1.72（95% CI 1.04 -2. 85）and 4. 05（95% CI 1.32 - 12.42） respectively,P = 0. 04,0.01. Conclusions ERCP is better than MRCP, to biliary tract or pancreatic diseases, in not only sensitivity but specificity. Doctors should think much about patients＇ situation, tolerance and cost-effectiveness, when they make a decision which examination should patients take.

关 键 词：胰胆管造影术 内窥镜逆行 胰胆管造影术 磁共振 荟萃分析 

分 类 号：R816.5[医药卫生—放射医学]