CT胆管成像与磁共振胆胰管成像鉴别良恶性胆道梗阻的诊断价值  

Diagnostic Values of CT Cholangiography and Magnetic Resonance Cholangiopancreatography in Differentiating Benign and Malignant Biliary Obstruction

作　　者：杨懿 朱宝林 Yang Yi;Zhu Baolin(Department of Imaging,Xinghua People's Hospital,Xinghua 225700,China)

机构地区：[1]兴化市人民医院影像科,江苏兴化225700

出　　处：《巴楚医学》2024年第1期92-96,共5页Bachu Medical Journal

基　　金：国家自然科学基金项目(No:81901797);江苏大学临床医学科技发展基金项目(No:JLY2021198)。

摘　　要：目的:探讨电子计算机断层扫描(CT)胆管成像与磁共振胆胰管成像(MRCP)对良恶性胆道梗阻的诊断价值。方法:选择2017年6月—2022年12月在兴化市人民医院接受诊治的胆道梗阻患者83例,所有患者均接受CT胆管成像及MRCP检查,比较这两种检查方法在鉴别良恶性胆道梗阻中的诊断价值。结果:以患者术后病理检查结果为金标准,分为恶性组23例和良性组60例。CT胆管成像检查中恶性组患者胆道狭窄(78.26%vs 36.67%)、胆道边缘模糊(69.57%vs 25.00%)及胆道形态变异(73.91%vs 28.33%)的发生率较良性组显著升高(均P<0.05)。MRCP检查中恶性组患者胆胰管汇合角度[(43.58±1.48)°vs(25.78±2.58)°]、胆总管直径(6.79±0.24 mm vs 4.78±0.32 mm)及胰管直径(2.99±0.13 mm vs 2.11±0.26 mm)显著高于良性组(均P<0.05)。CT胆管成像与MRCP对胆道梗阻良恶性的诊断敏感度分别为91.30%、95.65%,特异度分别为100.0%、100.0%,Kappa值分别为93.80%和97.00%。结论:CT胆管成像与MRCP在鉴别良恶性胆道梗阻方面都有较高的诊断价值。Objective:To evaluate the diagnostic value of computed tomography(CT)cholangiography and magnetic resonance cholangiopancreatography(MRCP)in benign and malignant biliary obstruction.Methods:A total of 83 patients with biliary obstruction who were treated in Xinghua People's Hospital from June 2017 to December 2022 were selected.All patients received CT cholangiography and MRCP.The diagnostic value of these two methods in distinguishing benign and malignant biliary obstruction was compared.Results:The patients were divided into the malignant group(23 cases)and the benign group(60 cases)according to the gold standard of pathological examination.In CT cholangiography,the incidence of biliary stenosis(78.26%vs 36.67%),biliary margin blur(69.57%vs 25.00%)and biliary morphological variation(73.91%vs 28.33%)in the malignant group were significantly higher than those in the benign group(all P<0.05).In MRCP examination,the confluent angle[(43.58±1.48)°vs(25.78±2.58)°],diameter of common bile duct(6.79±0.24 mm vs 4.78±0.32 mm)and diameter of pancreatic duct(2.99±0.13 mm vs 2.11±0.26 mm)in the malignant group were significantly higher than those in the benign group(all P<0.05).The sensitivity of CT cholangiography and MRCP in the diagnosis of benign and malignant biliary obstruction was 91.30%and 95.65%,the specificity was 100.0%and 100.0%,and Kappa value was 93.80%and 97.00%,respectively.Conclusion:CT cholangiography and MRCP both have high diagnostic value in differentiating benign and malignant biliary obstruction.

关 键 词：磁共振胆胰管成像 CT胆管成像 恶性胆道梗阻 良性胆道梗阻 

分 类 号：R445[医药卫生—影像医学与核医学]