常规MRCP检查用于胆囊结石患者行LC手术前的价值探讨  

Value of Routine MRCP in Patients with Gallstones Before LC

作　　者：江烨[1] 茅竞文 杨玲 宋丹华[1] JIANG Ye;MAO Jing-wen;YANG Ling;SONG Dan-hua(Department of Radiology,Qidong Hospital of Traditional Chinese Medicine,Qidong,Jiangsu Province,226200 China)

机构地区：[1]江苏省启东市中医院放射科

出　　处：《系统医学》2019年第12期27-29,共3页Systems Medicine

摘　　要：目的探讨胆囊结石腹腔镜胆囊切除术(LC)前行常规磁共振胰胆管造影(MRCP)的临床价值。方法以2016年1月—2018年12月为时限,择取该院54例胆囊结石患者,全部入选病例均以LC手术进行治疗,术前接受超声检查和MRCP检查,以术中探查结果为金标准,比较两种诊断方法胆管结石与胆道变异的检出情况。结果基于金标准,MRCP诊断胆总管结石灵敏度100.00%,阴性预测值100.00%,诊断符合率98.15%,均高于B超(χ^2=4.537、3.409、3.271,P<0.05)。术前MRCP诊断胆道变异阳性检出率(24.07%)高于B超,差异有统计学意义(χ^2=4.937,P<0.05)。结论常规MRCP可以较好的检出胆囊结石合并胆总管结石及胆道变异,对预防LC术中胆道损伤、提高结石清除效果具有积极作用。Objective To evaluate the clinical value of conventional magnetic resonance cholangiopancreatography(MRCP)before laparoscopic cholecystectomy(LG).Methods From January 2016 to December 2018,54 cases of cholecystolithiasis in our hospital were selected.All cases were treated by LC operation.Ultrasound and MRCP were performed before operation.The results of intraoperative exploration were used as gold standard.The detection of biliary duct stones and biliary tract variations were compared between the two diagnostic methods.Results Based on the gold standard,the sensitivity of MRCP in the diagnosis of common bile duct stones was 100.00%,the negative predictive value was 100.00%,and the diagnostic coincidence rate was 98.15%,which were higher than B-ultrasound(χ^2=4.537,3.409,3.271;P<0.05).The preoperative MRCP diagnosis of biliary tract mutation positive rate(24.07%)was higher than B-ultrasound,the difference was statistically significant(χ^2=4.937,P<0.05).Conclusion Conventional MRCP can better detect cholecystolithiasis with common bile duct stones and biliary tract variations.It plays an active role in preventing bile duct injury and improving stone clearance rate during LC.

关 键 词：胆囊结石 LC手术 MRCP检查 胆总管结石 胆道变异 

分 类 号：R657[医药卫生—外科学]