磁共振胰胆管造影术与经内镜逆行胰胆管造影术诊断阻塞性黄疸的价值评价  

Evaluation of Diagnostic Value of Magnetic Resonance Cholangiopancreatography and Endoscopic Retrograde Cholangiopancreatography in Obstructive Jaundice

作　　者：杨明[1] 张文杰[1] 陈权海[1] 全志伟[1] 

机构地区：[1]上海第二医科大学附属新华医院普外科,200092

出　　处：《胃肠病学》2000年第3期174-176,共3页Chinese Journal of Gastroenterology

摘　　要：目的：比较磁共振胰胆管造影术（MRCP）与经内镜逆行胰胆管造影术（ERCP）对阻塞性黄疸的诊断价值。方法：55例阻塞性黄疸患者分别行MRCP和ERCP，其中1例行ERCP失败者改行经皮肝胆管造影术（PTC）。MRCP采用重T2加权及超快速自旋回波水成像技术进行，ERCP和PTC按常规方法进行。结果：MRCP与ERCP（或PTC）总的诊断准确率分别为90．9％（50／55）和98．2％（54／55），对恶性狭窄的诊断准确率为73．7％（14／19）和94．7％（18／19），对胆总管结石的诊断准确率均为100％（30／30）。结论：MRCP为无创性检查，漏诊率较低但误诊率较高，在明确阻塞性黄疸病因时虽可作为首选方法，但不能取代ERCP（或PTC），两者结合使用可以弥补对方的不足，提高对阻塞性黄疸病因诊断的准确率。Background/Aims: To compare the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) in obstructive jaundice. Methods: MRCP and ERCP were performed in 55 patients with obstructive jaundice. One patientunderwent percutaneous transhepatic cholangiography (PTC) for being failed in the performance ofERCP. The technique of T2-weighted fast spin-echo fluid image was used in MRCP. ERCP and PTCwere performed in routine way. Results: The overall concordance rates of MRCP and ERCP (or PTC)were 90.9% (50/55) and 98.2% (54/55), respectively. In malignant common duct stricture the concordance rates of MRCP and ERCP were 73.7% (14/19) and 94.7% (18/19), respectively. In choledocholithiasis the concordance rates of both MRCP and ERCP were 100% (30/30). Conclusions: MRCP canexactly show the obstructive position and have the superiority of non-invasion and low rate of leakagealthough with the high misdiagnostic rate. It can be the first choice as a diagnostic method for obstructive jaundice, but it can not displace ERCP (or PTC) in a general sense, however, these two methodsare complementary, which can promote the rate of accuracy of diagnosis.

关 键 词：磁共振成像 胰胆管造影术 内窥镜逆行 黄疸 

分 类 号：R445.2[医药卫生—影像医学与核医学]