3.0T MRI漏诊肝外胆管结石的特征分析及对策

发布时间：2019-03-08 12:08

【摘要】：目的 :回顾性分析经内镜下逆行胰胆管造影(Endoscopic retrograde cholangiopancreatography,ERCP)确诊的肝外胆管结石的3.0T MRI的影像特征,探讨其漏诊原因。方法:收集河北医科大学第二医院2009年6月—2014年10月56例同时行MRI(包含常规平扫及磁共振胰胆管水成像)及ERCP检查的可疑肝外胆管结石患者,分析MRI图像,并与ERCP结果对照。结果:3.0T MRI诊断肝外胆管结石的漏诊率为30.23%(13/43)。将结石按最大径划分,5 mm为大结石,≤5 mm为小结石,其余近似流体样结石为泥沙样结石。其中泥沙样结石的漏诊率为100%,小结石的漏诊率为30.77%,大结石的漏诊率为12.5%,不同大小结石的漏诊率之间有明显差异(χ~2=15.938,P=0.0001),随肝外胆管结石最大径增大,MRI检查漏诊率下降。肝外胆管扩张患者结石的漏诊率为20%(6/30),肝外胆管不扩张患者结石的漏诊率为53.85%(7/13),肝外胆管扩张和不扩张患者的漏诊率之间存在明显差异(χ~2=4.926,P=0.026),肝外胆管不扩张患者漏诊率比肝外胆管扩张患者高。结论 :3.0T MRI漏诊肝外胆管结石受其大小、位置、胆管扩张情况等多重因素影响。
[Abstract]:Aim: to analyze retrospectively the imaging features of 3.0 T MRI of extrahepatic bile duct stones diagnosed by endoscopic retrograde cholangiopancreatography (Endoscopic retrograde cholangiopancreatography,ERCP) and to explore the causes of missed diagnosis. Methods: from June 2009 to October 2014, 56 patients with suspected extrahepatic bile duct stones underwent MRI (including conventional plain scan and magnetic resonance cholangiopancreatography) and ERCP. The MRI images were analyzed. The results were compared with the results of ERCP. Results: the missed diagnosis rate of 3.0 T MRI diagnosis of extrahepatic bile duct stones was 30.23% (13 / 43). According to the maximum diameter, the calculi were classified as large stones at 5 mm, small stones with 鈮，

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