摘要
目的探讨磁共振胰胆管成像(MRCP)在胆囊疾病中诊断及鉴别诊断的价值。方法收集经手术、病理或者其他临床资料证实共计110例胆囊及周围胆道系统良恶性病变,所有患者皆行1.5T MRI MRCP检查且显示其有胆道梗阻征象,其中良性为76例,包括胆总管结石40例,胆囊炎20例,胆囊结石12例,先天性胆总管囊肿4例;恶性34例,包括胆囊癌侵犯胆总管10例,胰头癌10例,胆管癌9例,壶腹部癌5例。结果MRCP技术能够直观、清晰的显示良恶性胆囊及其周围胆道系统疾病发生的部位、形态、大小;MRCP显示胆道梗阻形态和病灶良恶性密切相关,其诊断的敏感性、特异性、阳性预测值、阴性预测值分别为92%、83%、79%、98%;扩张形态与病灶良恶性相关,其诊断的敏感性、特异性、阳性预测值、阴性预测值分别为92%、93%、86%、99%;扩张程度与病灶良恶性相关,其诊断的敏感性、特异性、阳性预测值、阴性预测值分别为70%、57%、50%、76%。结论MRCP作为一种成熟的无创检查手段,对胆囊及其周围胆道系统疾病的诊断及鉴别诊断具有很高的价值,为临床后续治疗提供了精准、可靠的依据。
Objective Explore the value of magnetic resonance pancreatic bile duct imaging(MRCP)in the diagnosis and differential diagnosis of gallbladder disease.Methods A total of 110 cases of benign and malignant lesions of the gallbladder and surrounding biliary system were confirmed by surgery,pathology or other clinical data.All patients underwent 1.5 t mri mrcp examination and showed signs of biliary obstruction,including 76 cases of benign choledocholithiasis,40 cases of cholecystitis,20 cases of cholecystitis,12 cases of cholecystolithiasis,4 cases of congenital choledochal cyst.Results MRCP can directly and clearly show the location,shape and size of benign and malignant gallbladder and its peripheral biliary system diseases;mrcp shows that the morphology of biliary obstruction is closely related to the benign and malignant lesions,and its diagnostic sensitivity,specificity,positive predictive value,negative predictive value are 92%,83%,79%,98%,respectively;dilatation form is related to the benign and malignant lesions,and its diagnostic sensitivity,specificity,positive predictive value,negative predictive value are 92%,93%,86%,99%,respectively;The degree of dilatation was related to the benign and malignant lesions,and the sensitivity,specificity,positive predictive value and negative predictive value of the diagnosis were 70%,57%,50%and 76%,respectively.Conclusion As a mature non-invasive examination method,mrcp has high value in the diagnosis and differential diagnosis of gallbladder and its peripheral biliary system diseases,and provides a precise and reliable basis for clinical follow-up treatment.
作者
张汇斌
史晓飞
蒋哲
赵雷
王军
哈九大
孙旭东
范影
ZHANG Hui-bin;SHI Xiao-fei;JIANG Zhe(Anhui Taihe County People’s Hospital,Taihe 236600,China)
出处
《肝胆外科杂志》
2021年第4期292-296,共5页
Journal of Hepatobiliary Surgery
关键词
磁共振胰胆管造影
胆囊
无创
鉴别诊断
magnetic resonance cholangiopancreatography
gallbladder
non-invasive
differential diagnosis
