超声内镜联合磁共振胰胆管造影术诊断胆总管结石的临床价值  

Clinical value of endoscopic ultrasonography combined with magnetic resonance cholangiography in diagnosis of stones in common bile duct

作　　者：吴军霞 陈佳佳[2] 黄权芳 WU Junxia;CHEN Jiajia;HUANG Quanfang(Department of Gastroenterology, People＇s Hospital of Shaoxing （ Shaoxing Hospital of Zhejiang University ）, Shaoxing 312000, CHINA)

机构地区：[1]绍兴市人民医院浙江大学绍兴医院消化内科,浙江312000 [2]绍兴市人民医院浙江大学绍兴医院超声科,浙江312000 [3]广西中医药大学科研室

出　　处：《江苏医药》2018年第4期397-399,共3页Jiangsu Medical Journal

基　　金：广西自然科学基金面上资助项目(83536)

摘　　要：目的探讨超声内镜(EUS)联合磁共振胰胆管造影术(MRCP)诊断胆总管结石的临床价值。方法胆总管结石患者108例随机均分为腹部超声(TUS)组和EUS组。TUS组应用TUS联合MRCP,EUS组应用EUS联合MRCP。观察两组术中取石结果、胆道镜探查结果及诊断胆总管结石的灵敏度、特异度、阳性预测值(PPV)、阴性预测值及准确率。结果以内镜取出结石为金标准,EUS组的灵敏度(97.62%vs.76.92%)及准确率(94.44%vs.77.78%)高于TUS组(P<0.05)。EUS组对<0.5cm胆总管结石的PPV大于TUS组(91.67%vs.50.00%)(P<0.05)。结论与TUS联合MRCP比较,EUS联合MRCP在诊断胆总管结石方面更具有优势,特别是在胆总管末端的微小结石诊断上优势明显。Objective To study the clinical value of endoscopic ultrasonography （EUS） combined with magnetic resonance cholangiography（MRCP） in the diagnosis of stones in the common bile duct. Methods A total of 108 patients with common bile duct stones was equally divided into two groups. The patients in group A were treated by abdominal ultrasound（TUS） combined with MRCP. The patients in group B were treated by EUS combined MRCP. The results were compared between two groups. Results Taking stone removal by endoscopy as the gold standard, the sensitivity and accuracy in the diagnosis of stones in the common bile duct were higher in group B than those in group A（97.62% vs. 76.92% and 94. 44% vs. 77.78%） （P〈0. 05）. The positive predictive value of diagnosing the stones less than 0. 5 cm was higher in group B than that in group A（91.67% vs. 50. 00%）（P=0. 050）. Conclusion Compared with TUS combined with MRCP, EUS combined with MRCP has more advantages in the diagnosis of common bile duct stones, especially in detecting small stones less than 0. 5 cm located at the end of common bile duct.

关 键 词：超声内镜 磁共振胰胆管造影术 腹部超声 

分 类 号：R445[医药卫生—影像医学与核医学]