胆囊结石合并胆囊炎患者MRCP表现及其诊断价值  

Manifestations and diagnostic value of MRCP in patients with cholecystolithiasis complicated with cholecystitis

作　　者：蔡文静 程南生[1] 金张龙 CAI Wenjing;CHENG Nansheng;JIN-ZHANG Long(Imaging Center,Anqing First People’s Hospital of Anhui Province,Anhui Province,Anqing246003,China)

机构地区：[1]安徽省安庆市第一人民医院影像中心,安徽安庆246003

出　　处：《中国医药导报》2022年第4期153-156,共4页China Medical Herald

摘　　要：目的探究胆囊结石合并胆囊炎患者磁共振胰胆管成像(MRCP)的表现及其诊断价值。方法回顾性分析2018年7月至2021年4月安徽省安庆市第一人民医院者行腹腔镜下胆囊切除术的80例患者的临床资料,受试者在术前均接受上腹部MRCP检查和彩色超声检查。观察胆囊结石合并胆囊炎患者的MRCP、彩色超声表现,比较MRCP、彩色超声在胆囊结石合并胆囊炎上的诊断效能,绘制受试者操作特征曲线,计算曲线下面积。结果37例被明确诊断为胆囊结石合并胆囊炎,其余43例为慢性胆囊炎。MRCP检查结果中,37例胆囊结石合并胆囊炎患者中有33例被明确诊断,胆囊均可见明显扩张,胆总管、左右胆管、胰管显示清晰,管道内均可见结石数目不一,形态呈圆形、椭圆形、条形及不规则形。彩色超声明确诊断24例,均可见胆囊明显扩张,管道及结石显示清晰。MRCP诊断胆囊结石合并胆囊炎的敏感度、特异性和准确度分别为89.19%、97.67%和93.75%。MRCP的曲线下面积明显高于彩色超声,差异有高度统计学意义(P<0.01)。结论MRCP诊断胆囊结石合并胆囊炎的准确率高于彩色超声。术前进行MRCP检查对于疑似有胆囊结石的胆囊炎患者的意义重大,值得在临床上积极推广。Objective To explore manifestations and diagnostic value of magnetic resonance cholangiopancreatography(MRCP)in patients with cholecystolithiasis complicated with cholecystitis.Methods The clinical data of 80 patients who underwent laparoscopic cholecystectomy in Anqing First People’s Hospital of Anhui Province from July 2018 to April 2021 were retrospectively analyzed.All subjects underwent upper abdominal MRCP examination and color ultrasound examination before surgery.MRCP and color ultrasound manifestations of patients with cholecystolithiasis complicated with cholecystitis were observed,and the diagnostic efficacy of MRCP and color ultrasound in cholecystolithiasis complicated with cholecystitis was compared.The receiver operator characteristic curve was drawn and the area under the curves was calculated.Results A total of 37 cases were diagnosed as cholecystolithiasis complicated with cholecystitis,and the remaining 43 cases were chronic cholecystitis.Among MRCP examination results,33 patients with cholecystolithiasis complicated with cholecystitis were clearly diagnosed in 37 patients,the gallbladder was obviously dilated,and the common bile duct,left and right bile ducts,and pancreatic duct were clearly displayed,different numbers of stones were seen in the duct,with round,oval,strip,and irregular shapes.A total of 24 cases were diagnosed clearly by color ultrasound,the gallbladder was obviously dilated and the ducts and stones were clearly displayed.The sensitivity,specificity,and accuracy of MRCP in the diagnosis of cholecystolithiasis complicated with cholecystitis were 89.19%,97.67%,and 93.75%,respectively.The area under curve of MRCP was significantly higher than that of color ultrasound,and the difference was highly statistically significant(P<0.01).Conclusion The accuracy of MRCP in the diagnosis of cholecystolithiasis complicated with cholecystitis is higher than that of color ultrasound.Preoperative MRCP examination is of great significance for patients with cholecystitis suspected of having ga

关 键 词：胆囊结石 胆囊炎 磁共振胰胆管成像 腹腔镜下胆囊切除术 

分 类 号：R657.4[医药卫生—外科学]