MRCP诊断不同直径、不同部位胆总管结石的价值  

The Value of MRCP in the Diagnosis of Common Bile Duct Stones of Different Diameters and Locations

作　　者：张小斌 李宁 陈亚明[1] ZHANG Xiao-bin;LI Ning;CHEN Ya-ming(Wanbei Coal Power Group General Hospital(Imaging Department),Suzhou 234000,Anhui Province,China)

机构地区：[1]皖北煤电集团总医院(影像科),安徽宿州234000

出　　处：《中国CT和MRI杂志》2023年第4期110-111,114,共3页Chinese Journal of CT and MRI

摘　　要：目的探究磁共振胰胆管造影(MRCP)诊断不同直径、不同部位胆总管结石(CBDS)的价值。方法选取2019年9月至2022年9月我院175例疑似CBDS患者,均行术前超声、CT及MRCP,以内镜下逆行胰胆管造影术(ERCP)检查结果为“金标准”,统计术前超声、CT及MRCP诊断CBDS的结果,比较3种方法诊断CBDS的价值,并比较超声、CT、MRCP诊断不同直径、不同部位CBDS的准确度,根据术前MRCP诊断结果选择手术方案,统计一次取石成功率。结果基于ERCP检查结果的“金标准”,术前MRCP诊断CBDS的敏感度(95.83%)、准确度(95.43%)均高于超声、CT诊断(P<0.05);MRCP诊断结石直径<5 mm CBDS的准确度(88.00%)均高于超声、CT诊断,诊断直径5~10 mm CBDS的准确度(96.83%)高于超声诊断(P<0.05),诊断直径>10 mm CBDS的准确度为100.00%;MRCP诊断上段CBDS的准确度(96.88%)均高于超声、CT诊断,诊断胰腺段CBDS的准确度(92.68%)高于超声诊断(P<0.05),诊断壶腹段CBDS的准确度为100.00%。结论MRCP诊断CBDS的敏感度、准确度较高,在不同直径、不同部位CBDS诊断方面均具有很高准确度,可为手术取石提供可靠术前参考依据。Objective To investigate the value of magnetic resonance cholangiopancreatography(MRCP)in the diagnosis of common bile duct stones(CBDS)of different diameters and different locations.Methods 175 patients with suspected CBDS in our hospital from September 2020 to February 2022 were selected to undergo preoperative abdominal ultrasound,CT and MRCP examinations,and the results of preoperative ultrasound,CT and MRCP were used as the"gold standard"for diagnosing CBDS,comparing the value of the three imaging methods in diagnosing CBDS,and comparing the accuracy of ultrasound,CT and MRCP in diagnosing CBDS of different diameters and different locations,selecting the surgical plan according to the preoperative MRCP diagnostic results,and calculating the success rate of primary stone extraction.Results Based on the"gold standard"of ERCP findings,the sensitivity(95.83%)and accuracy(95.43%)of preoperative MRCP in diagnosing CBDS were higher than those of ultrasound and CT(P<0.05).The sensitivity(95.83%)and accuracy(95.43%)of MRCP diagnosis of CBDS were higher than those of ultrasound and CT diagnosis(P<0.05);the accuracy of MRCP diagnosis of stone diameter<5 mm CBDS(88.00%)was higher than those of ultrasound and CT diagnosis,and the accuracy of diagnosis of CBDS diameter 5-10 mm(96.83%)was higher than that of ultrasound diagnosis(P<0.05),and the accuracy of diagnosis of CBDS diameter>10 mm was 100.00%;MRCP The accuracy of diagnosing CBDS in the upper segment(96.88%)was higher than that of ultrasound and CT diagnosis,and the accuracy of diagnosing CBDS in the pancreatic segment(92.68%)was higher than that of ultrasound diagnosis(P<0.05),and the accuracy of diagnosing CBDS in the pot belly segment was 100.00%;the success rate of one stone extraction was 93.33%(112/120)when the surgical plan was selected according to the preoperative MRCP diagnosis.Conclusion MRCP has high sensitivity and accuracy in diagnosing CBDS with different diameters and different sites,and can provide a reliable preoperative reference basis for surgica

关 键 词：胆总管结石 磁共振胰胆管造影 结石直径 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]