腹部超声联合MRCP检查诊断可疑胆总管结石患者的价值  

Diagnostic Value of Abdominal Ultrasound Combined With MRCP in Patients With Suspected Common Bile Duct Stones

作　　者：周宇晶 李琪虹 ZHOU Yujing;LI Qihong(Department of Ultrasound Diagnosis,the 73^(rd)Group Military Hospital of the Chinese People′s Liberation Army,Xiamen Fujian 361000,China)

机构地区：[1]中国人民解放军陆军第七十三集团军医院超声诊断科,福建厦门361000

出　　处：《中国卫生标准管理》2025年第4期105-109,共5页China Health Standard Management

摘　　要：目的 探讨腹部超声联合磁共振胰胆管造影(magnetic resonance cholangio pancreatography,MRCP)检查诊断可疑胆总管结石(common bile duct stones,CBDS)患者的价值。方法 选取中国人民解放军陆军第七十三集团军医院2020年3月—2023年10月接受诊治的100例疑似CBDS患者,所有患者均开展腹部超声、MRCP及内镜下逆行胰胆管造影术(endoscopic retrograde cannulation of the pancreatic,ERCP)检查,以ERCP结果为“金标准”,对比各项诊断对不同直径、不同部位、不同成分CBDS与ERCP结果的符合率,并评估二者联合对CBDS的诊断效能。结果 100例CBDS患者中,ERCP检查确诊CBDS阳性64例(64.00%),阴性36例(36.00%)。在5~10 mm的CBDS检出率中,MRCP高于腹部超声,差异有统计学意义(P <0.05);其余不同大小的CBDS检出中,2种检查对比,差异无统计学意义(P> 0.05)。在胆总管下段的CBDS检出率中,MRCP略高于腹部超声,差异有统计学意义(P<0.05);其余不同部位的CBDS检出中,2种检查对比,差异无统计学意义(P> 0.05)。腹部超声胆色素结石检出率略高于MRCP,而MRCP胆固醇结石检出率略高于腹部超声,差异有统计学意义(P <0.05);但2组混合性结石检出率对比,差异无统计学意义(P> 0.05)。联合检测一致性较好,Kappa值为0.751;且对CBDS的敏感度高于其单独检测(P <0.05)。结论 腹部超声、MRCP在不同直径、部位、成分的结石诊断检出中各有优势,二者联合能够提高可疑CBDS的检出敏感度,可作为CBDS的初步筛查手段。Objective To explor the value of abdominal ultrasound combined with magnetic resonance cholangiopancreatography(MRCP)in the diagnosis of suspected common bile duct stones (CBDS) in patients. Methods A total of 100 suspected CBDS patients who received treatment at Army 73rd Group Military Hospital from March 2020 to October 2023 were selected. All patients underwent abdominal ultrasound, MRCP and endoscopic retrograde cholangiopancreatography (ERCP). Taking ERCP results as the "gold standard", the coincidence rates of CBDS and ERCP results with different diameters, different parts and different components were compared, and the diagnostic efficiency of the two methods were evaluated. Results Among 100 cases of CBDS, 64 cases (64.00%) were CBDS positive and 36 cases (36.00%) were negative by ERCP. In the CBDS detection rate of 5-10 mm, MRCP was higher than that of abdominal ultrasound, the difference was statistically significant (P < 0.05), and there were not difference between the two methods in the detection of other CBDS with different sizes (P > 0.05). In the detection rate of CBDS in the lower segment of common bile duct, MRCP was slightly higher than abdominal ultrasound, the difference was statistically significant (P < 0.05), and there were not difference between the two methods in the detection of CBDS in other different parts (P > 0.05). The detection rate of bile pigment stones by abdominal ultrasound was slightly higher than that by MRCP, while the detection rate of cholesterol stones by MRCP was slightly higher than that by abdominal ultrasound, the difference was statistically significant (P < 0.05), but there were not difference in the detection rate of mixed stones between the two groups (P > 0.05). The consistency of joint detection is good, Kappa value was 0.751. The sensitivity of CBDS was higher than that of CBDS alone (P < 0.05). Conclusion Abdominal ultrasound and MRCP have their own advantages in the diagnosis and detection of stones with different diameters, locations and components. The co

关 键 词：腹部超声 磁共振胰胆管造影 胆总管结石 诊断效能 内镜下逆行胰胆管造影术 敏感度 

分 类 号：R657[医药卫生—外科学]