多排螺旋CT与3.0T磁共振成像对肝外胆管结石的诊断效果分析

发布时间：2018-02-01 05:30

本文关键词： 磁共振成像体层摄影术螺旋计算机胆管肝外胆总管结石诊断　出处：《中国全科医学》2017年33期 　论文类型：期刊论文

【摘要】：背景多排螺旋CT(MDCT)与磁共振成像(MRI)均为目前临床辅助诊断肝外胆管结石的常用影像学检查方法,但这两种检查各有其优势与劣势。目的对比分析MDCT和3.0T MRI对肝外胆管结石的诊断价值,探讨临床医生如何为可疑胆管结石患者选择更合理的影像学检查方法。方法对2009-06-18至2014-10-21河北医科大学第二医院收治的56例可疑肝外胆管结石患者于经内镜逆行性胰胆管造影术(ERCP)前2周内行MDCT、3.0T MRI检查,以ERCP为金标准,计算并比较两种方法的灵敏度、假阴性率(漏诊率)、特异度、假阳性率(误诊率)等指标。结果 MDCT诊断肝外胆管结石的灵敏度、漏诊率、特异度、误诊率、阳性预测值及阴性预测值分别为25.6%、74.4%、100.0%、0、100.0%、28.9%,3.0T MRI诊断肝外胆管结石的灵敏度、漏诊率、特异度、误诊率、阳性预测值、阴性预测值分别为69.8%、30.2%、100.0%、0、100.0%、50.0%。3.0T MRI诊断肝外胆管结石的灵敏度高于MDCT,漏诊率低于MDCT(P0.001)。两种方法诊断肝外胆管结石的特异度和误诊率相同。结论临床怀疑肝外胆管结石的患者,若条件允许,建议首选MRI检查。
[Abstract]:Background MDCT and MRI are commonly used in clinical diagnosis of extrahepatic cholelithiasis. But each of them has its own advantages and disadvantages. Objective to compare and analyze the value of MDCT and 3.0T MRI in the diagnosis of extrahepatic cholelithiasis. To explore how clinicians choose more reasonable imaging methods for patients with suspected cholelithiasis. Methods 56 patients admitted to the second Hospital of Hebei Medical University from 2009-06-18 to 2014-10-21. Cases of suspected extrahepatic cholelithiasis underwent endoscopic retrograde cholangiopancreatography (. MDCT was performed in the first 2 weeks. The sensitivity and false negative rate (false negative rate) of the two methods were calculated and compared using ERCP as gold standard. Results the sensitivity, missed diagnosis rate, specificity, misdiagnosis rate, positive predictive value and negative predictive value of MDCT in the diagnosis of extrahepatic cholelithiasis were 25.6%, respectively. The sensitivity, missed diagnosis rate, specificity, misdiagnosis rate and positive predictive value of MRI in the diagnosis of extrahepatic bile duct stones were 28.9T and 3.0T, respectively. The negative predictive values were 69.8% and 30.2%, respectively. The sensitivity of MRI was higher than that of MDCT in the diagnosis of extrahepatic cholelithiasis. The rate of missed diagnosis was lower than that of MDCT P0.001. The specificity and misdiagnosis rate of the two methods were the same. Conclusion the patients with suspected extrahepatic cholelithiasis are clinically suspected, if conditions permit. The preferred MRI check is recommended.
【作者单位】：河北医科大学第二医院医学影像科;河北省中医院放射科;河北医科大学第二医院肿瘤外科;河北医科大学第二医院微创外科;河北省直属机关第一门诊部超声科;
【分类号】：R445.2;R575.62;R816.5
【正文快照】： 1.050000河北省石家庄市,河北医科大学第二医院医学影像科2.050000河北省石家庄市,河北省中医院放射科3.050000河北省石家庄市,河北医科大学第二医院肿瘤外科4.050000河北省石家庄市,河北医科大学第二医院微创外科5.050051河北省石家庄市,河北省直属机关第一门诊部超声科Compa

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