MRCP与ERCP对低位梗阻性黄疸诊断价值的比较

Comparison of diagnostic value between MRCP and ERCP in detection of low-set obstructive jaundice

目的评价磁共振胰胆管造影术(MRCP)和内窥镜逆行胰胆管造影(ERCP)在低位梗阻性黄疸中的诊断价值。方法将78例经B型超声证实为低位梗阻性黄疸的病人随机分为2组(均无禁忌证),其中1组40例行MRCP检查,另1组38例行ERCP检查。通过对比检查后并发症、淀粉酶、脂肪酶以及诊断准确度来比较两者的诊断价值。结果ERCP术后病人的并发症发病率明显高于行MRCP检查的病人(P<0.01),ERCP检查后病人的淀粉酶和脂肪酶水平高于MRCP术后的病人(P<0.05),两者诊断准确度经比较无差异(P>0.05)。结论对低位梗阻性黄疸病人的诊断应首选MRCP,需作进一步确诊时再选用ERCP。

Objective To evaluate the diagnostic value of magnetic resonance eholangiopanerea- to graphy（MRCP）versus endoscopic retrograde eholangiopanereatography（ERCP）prospectively in detection of low-set obstructive jaundice. Methods Seventy-eight patients with low-set obstructive jaundice confirmed by ultrasound B were randomly divided into two groups., one group of 40 patients received MRCP examination and the remaining 38 ERCP examination. The complications, levels of amylase and lipase and accuracy rate of diagnosis were compared to evaluate diagnostic value of MRCP and ERCP. Results Complications caused by ERCP were more than those by MRCP（P〈0. 01）. Levels of amylase and lipase after ERCP were higher than after ERCP （P〈0. 05）. There was no significant difference in the accuracy rate of diagnosis between MRCP and ERCP（P〉0. 05）. Conclusion Patients who have been suspected to be suffered from low-set obstructive jaundice by ultrasound B should be examined by MRCP to confirm firstly,and then further to be examined by ERCP if necessary.