3D MRCP联合薄层T2WI序列诊断胆总管下段结石的价值分析  

Value Analysis of 3D MRCP Combined with Thin-Layer T2WI Sequence in the Diagnosis of Lower Common Bile Duct Stones

作　　者：齐武[1] 梁丁保[1] 詹志敏 黄俊[2] QI Wu;LIANG Dingbao;ZHAN Zhimin;HUANG Jun(Department of Gastroenterology,The PLA Navy Anqing Hospital,Anqing Anhui 246000,China;Department of Imaging,The PLA Navy Anqing Hospital,Anqing Anhui 246000,China)

机构地区：[1]中国人民解放军海军安庆医院消化内科,安徽安庆246000 [2]中国人民解放军海军安庆医院影像科,安徽安庆246000

出　　处：《中国医疗设备》2022年第9期61-64,75,共5页China Medical Devices

基　　金：2018年安徽省自然科学基金面上项目(1808085MH239)。

摘　　要：目的探讨3D磁共振胰胆管成像(Magnetic Resonance Cholangiopancreatography,MRCP)联合薄层T2WI序列诊断胆总管下段结石的价值。方法选取2019年12月至2021年12月我院收治的151例拟诊为胆总管下段结石的患者作为研究对象,入院后均行3D MRCP、薄层T2WI序列检测和经内镜逆行胰胆管造影术(Endoscopic Retrograde Cholangio-Pancreatography,ERCP)治疗。以ERCP治疗确诊或术后病理学结果作为“金标准”,比较3D MRCP、薄层T2WI序列两种方法单独诊断及联合诊断对胆总管下段结石的诊断价值,并计算敏感度、特异度、准确率。以“金标准”结果为依据,按照结石大小分组,比较不同影像学检查方法对不同大小结石的检出率。结果3D MRCP、薄层T2WI序列诊断胆总管下段结石的敏感度、特异度、准确率对比差异无统计学意义(P>0.05),3D MRCP联合薄层T2WI序列检测较两者单独检测敏感度、特异度、准确率更高(P<0.05)。经3D MRCP检查显示,151例患者中49.67%的患者胆系中重度扩张,33.77%的患者胆总管全程扩张,胆总管下段梗阻主要表现为液抱石征(24.50%)及下段信号减低(9.27%)。3D MRCP、薄层T2WI序列单独检测及联合检测对d>1 cm及5 mm<d≤1.0 cm检出率比较均无统计学意义(P>0.05),联合检测对d≤5 mm的结石检出率较两种诊断方法单独检测检出率更高(均P<0.05)。结论在3D MRCP的基础上联合薄层T2WI序列检测对胆总管下段结石的诊断准确率更高,更有利于d≤5 mm结石的检出。Objective To investigate the value of 3D magnetic resonance cholangiopancreatography(MRCP)combined with thin-layer T2WI sequence in the diagnosis of lower common bile duct stones.Methods A total of 151 patients with possible lower common bile duct stones between December 2019 and December 2021 in our hospital were selected as research subjects.All patients underwent 3D MRCP,thin-layer T2WI sequence detection and endoscopic retrograde cholangiopancreatography(ERCP)treatment after admission.Using ERCP treatment diagnosis or postoperative pathological results as the“gold standard”,the diagnostic value,calculation sensitivity,specificity and accuracy of 3D MRCP and thin-layer T2WI sequences for lower common bile duct stones were compared.Based on the gold standard results,the patients were grouped according to the size of stones.The detection rates of different imaging methods for different sizes of stones were compared.Results There were no statistically differences in the sensitivity,specificity and accuracy rate of 3D MRCP and thin-layer T2WI sequence in the diagnosis of lower common bile duct stones(P>0.05).The sensitivity,specificity and accuracy rate of 3D MRCP combined with thin-layer T2WI sequence were higher than those of the two alone(P<0.05).3D MRCP examination of 151 patients showed that there were 49.67%of patients with moderate-to-severe biliary dilation and 33.77%of patients with dilatation of common bile duct.The lower common bile duct obstruction was mainly manifested by liquid bouldering(24.50%)and decreased signal reduction(9.27%).There were no statistically significant differences in the detection rates of stones with d>1 cm and stones with 5mm<d≤1.0 cm by 3D MRCP alone,thin-layer T2WI sequence alone and combined detection(P>0.05),and the detection rate of combined detection for stones with d≤5 mm was higher than that of the two methods alone(P<0.05).Conclusion Based on 3D MRCP combined with thin-layer T2WI sequence detection has higher diagnostic accuracy rate of lower common bile duct st

关 键 词：磁共振胰胆管成像 薄层T2WI序列 内镜逆行胰胆管造影术 胆总管下段结石 

分 类 号：R816.5[医药卫生—放射医学]