胆囊结石合并胆囊炎患者磁共振胰胆管造影表现及其诊断价值  

Manifestations and Diagnostic Value of Magnetic Resonance Cholangiopancreatography in Patients with Cholecystolithiasis Complicated with Cholecystitis

作　　者：祝业 蔡朝君 戴亚楠 ZHU Ye;CAI Chaojun;DAI Yanan(Department of Medical Imaging,Dantu District People's Hospital of Zhenjiang City,Zhenjiang 212028,Jiangsu,China)

机构地区：[1]镇江市丹徒区人民医院医学影像科,江苏镇江212028

出　　处：《世界复合医学(中英文)》2024年第12期164-167,共4页World Journal of Complex Medicine

摘　　要：目的探讨磁共振胰胆管造影对胆囊结石合并胆囊炎的诊断价值及图像表现。方法选择2020年11月—2023年12月镇江市丹徒区人民医院收治的86例疑似胆囊结石合并胆囊炎患者,均予磁共振胰胆管造影检查。以手术病理结果为金标准,评估磁共振胰胆管造影的诊断效能及对不同直径结石的诊断符合率,并分析磁共振胰胆管造影图像特征。结果手术病理结果证实阳性57例、阴性29例。磁共振胰胆管造影诊断胆囊结石合并胆囊炎的准确度为95.35%(82/86)、灵敏度为94.74%(54/57)、特异度为96.55%(28/29)、阳性预测值为98.18%(54/55)、阴性预测值为90.32%(28/31),与手术病理的一致性较好(kappa值为0.898)。磁共振胰胆管造影对直径<0.5 cm、0.5~1.0 cm、>1.0 cm结石诊断符合率分别为80.00%(4/5)、93.33%(28/30)、100.00%(22/22)。经磁共振胰胆管造影确诊的54例患者中,磁共振胰胆管造影典型征象为:胆囊扩张,胆管胰管图像良好且内部存在结石,结石形态各异。结论磁共振胰胆管造影对胆囊结石合并胆囊炎的诊断效能较高,对不同直径结石均有良好的检出率,图像特征明显。Objective To investigate the diagnostic value and image manifestations of magnetic resonance cholangiopancreatography in cholecystolithiasis complicated with cholecystitis.Methods From November 2020 to December 2023,a total of 86 patients with suspected cholecystolithiasis complicated with cholecystitis admit-ted to the Dantu District People's Hospital of Zhenjiang City were selected for magnetic resonance cholangio-pancreatography.With surgical pathology result as the gold standard,the diagnostic efficacy of magnetic reso-nance cholangiopancreatography and the diagnostic coincidence rate for stones of different diameters were evaluated,and the image features of magnetic resonance cholangiopancreatography were analyzed.Results Sur-gical pathology result confirmed positive in 57 cases,negative in 29 cases.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of magnetic resonance cholangiopancreatography in the diagnosis of cholecystolithiasis complicated with cholecystitis were 95.35%(82/86),94.74%(54/57),96.55%(28/29),98.18%(54/55)and 90.32%(28/31),respectively.The consistency with surgical pathology result was good(kappa value was 0.898).The diagnostic coincidence rates of magnetic resonance cholangiopancreatogra-phy for stones with diameters of<0.5 cm,0.5-1.0 cm and>1.0 cm were 80.00%(4/5),93.33%(28/30)and 100.00%(22/22),respectively.Among the 54 patients diagnosed by magnetic resonance cholangiopancreatogra-phy,the typical signs of magnetic resonance cholangiopancreatography were:gallbladder dilatation,good bile duct and pancreatic duct images and internal stones,and different stone shapes.Conclusion Magnetic reso-nance cholangiopancreatography has a high diagnostic efficiency for cholecystolithiasis complicated with chole-cystitis.It has a good detection rate for stones of different diameters,and the image features are obvious.

关 键 词：胆囊结石 胆囊炎 磁共振胰胆管造影 胆囊切除 

分 类 号：R44[医药卫生—诊断学]