磁共振胰胆管水成像对胆管变异评估的临床价值  

Clinical value of magnetic resonance cholangiopancreatography in the evaluation of bile duct variability

作　　者：李润霞 刘清波 杨涝 LI Run-xia;LIU Qing-bo;YANG Lao(Magnetic Resonance Laboratory,Yulin Traditional Chinese Medicine Hospital,Yulin 719000,Shaanxi,CHINA;Department of Radiology,Gaoling District Hospital of Traditional Chinese Medicine,Xi'an 710200,Shaanxi,CHINA)

机构地区：[1]榆林市中医医院磁共振室,陕西榆林719000 [2]西安市高陵区中医医院放射科,陕西西安710200

出　　处：《海南医学》2019年第16期2131-2133,共3页Hainan Medical Journal

摘　　要：目的探讨磁共振胰胆管水成像(MRCP)对胆管变异诊断的临床价值。方法对2017年2月至2019年1月榆林市中医医院1 200例拟行胆囊切除术患者行MRCP,并以胆道造影(IOC)作为诊断标准,观察胆管变异的类型,计算MRCP的诊断敏感性、特异性、阳性预测值、阴性预测值和诊断符合率。结果本组1 200例患者行IOC共发现91例患者存在胆管变异,变异率为7.58%(91/1200);MRCP共发现95例,MRCT的诊断敏感性为92.63%(88/95)、特异性为99.73%(1 104/1107)、阳性预测值为96.70%(88/91)、阴性预测值为99.37%(1 104/1 111)、诊断符合率为99.33%(1 192/1 200);MRCP下发现胆囊管低位汇入所占比例最高,为55.78%(53/95),其次为胆囊管内侧插入,占25.26%(24/95);MRCP对不同胆道变异类型诊断与OIC检查结果基本一致。结论通过磁共振胰胆管造影检查可全面了解胆树图像,并能够准确的发现胆管变异变异。Objective To evaluate the clinical value of magnetic resonance cholangiopancreatography(MRCP)in the diagnosis of bile duct variability.Methods MRCP was performed in 1 200 patients who scheduled for cholecystectomy in Yulin Traditional Chinese Medicine Hospital from February 2017 to January 2019.Intraoperative cholangiography(IOC)was used as diagnostic criteria to observe the type of bile duct variation,and to calculate the diagnostic sensitivity,specificity,positive predictive value,negative predictive value,and the diagnostic coincidence rate of MRCP.Results Among the 1,200 patients,91 patients were found to have bile duct variation by IOC,with a variation rate of 7.58%(91/1 200);and 95 patients were found by MRCP.The diagnostic sensitivity of MRCT was 92.63%(88/95),the specificity was 99.73%(1 104/1 107),the positive predictive value was 96.70%(88/91),the negative predictive value was 99.37%(1 104/1 111),and the diagnostic coincidence rate was 99.33%(1 192/1 200).Under MRCP,the low cystic duct insertion has the highest proportion of 55.78%(53/95),followed by the medial cystic duct insertion,accounting for 25.26%(24/95).The diagnostic results of different bile duct variations by MRCP were basically consistent with the results of IOC.Conclusion Through magnetic resonance cholangiopancreatography,the image of biliary tree can be fully understood and the bile duct variation can be accurately detected.

关 键 词：磁共振胆胰管成像 胆管变异 胆道造影 胆囊管低位汇入 胆囊 胆管 

分 类 号：R657.4[医药卫生—外科学]