内镜超声和经内镜逆行胰胆管造影在慢性胰腺炎诊断中的价值  

Endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in chronic pancreatitis

作　　者：王洛伟[1] 李兆申[1] 金震东[1] 邹多武[1] 李淑德[1] 陈浮[1] 

机构地区：[1]第二军医大学长海医院消化内科,上海200433

出　　处：《中华消化内镜杂志》2008年第7期362-365,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的评价EUS和ERCP对慢性胰腺炎（CP）的诊断灵敏度和特异度，探讨在cP诊断中EUS和ERCP的价值。方法采用多中心联合调查方法，回顾分析1994年5月至2004年5月全国22个分研究中心的确诊的cP病例，以组织学诊断为“金标准”，采用接受者工作曲线（receiver operating characteristic，ROC）分析EUS和ERCP的诊断灵敏度和特异度。结果共入选CP患者1994例，男1298例，女696例。年龄5～85（48．94±15．0）岁。所有CP患者中，有组织学诊断239例（11．98％）；胰腺外分泌功能试验（BT-PABA）261例（13．09％），腹部平片416例（20．86％），腹部B超1424例（71、41％），CT889例（44．58％），MRI和MRCP245例（12．29％），ERCP628例（31．49％），EUS258例（12．94％）。各诊断方法的诊断灵敏度和特异度分别为EUS（88％和93％）、ERCP（87％和93％）、MRI和MRCP（66％和85％）、CT（61％和85％）、B超（69％和82％）、腹部平片（32％和80％）、BT-PABA（83％和80％）。结论在CP诊断方法中，EUS和ERCP对CP且具有较高的灵敏度和特异度，EUS较ERCP灵敏度和特异度更高。Objective To evaluate the sensitivity and specificity of endoscopic ultrasonography （EUS） and endoscopic retrograde cholangiopancreatography （ERCP） in diagnosis of chronic pancreatitis （CP）. Methods Data of histologically confirmed CP cases, from May 1994 to May 2004 in 22 Chinese hospitals, were retrospectively analyzed. The receiver operating characteristic （ROC） was used to compare the sensitivity and specificity of EUS and ERCP. Results The data of 1994 CP cases were retrieved, including 1298 males and 696 females, aging from 5 to 85 （48. 9 ± 15.0 ）. The diagnosis of CP was confirmed histologically in 239 patients （ 11.98% ） , and pancreatic exocrine function test（BT-PABA） were employed in 261 patients（ 13.09% ）, X-ray in 419（20. 86% ）, B ultrasonography in 1424（71.41% ）, CT in 889 （44.58%） , magnetic resonance imaging（MRI） and magnetic resonance cholangiopancreatography （MRCP） in 245 （ 12.29% ）, ERCP in 628 （31.49% ） , and EUS in 258 （ 12.94% ）. The sensitivity and specificity of each method were as follows： 88% and 93% for EUS, 87% and 93% for ERCP, 66% and 85% for MRI and MRCP, 61% and 85% for CT, 69% and 82% for B ultrasonography, 32% and 80% for X ray, 83% and 80% for BT-PABA. Conclusion Of all the diagnostic methods, EUS and ERCP are the most sensitive and specific to diagnose of CP, while EUS is of the highest.

关 键 词：内窥镜超声检查 胰胆管造影术 内窥镜逆行 胰腺炎 慢性 诊断 

分 类 号：R57[医药卫生—消化系统]