磁共振胰胆管成像与经内镜逆行胰胆管造影对胆胰疾病诊断价值的比较研究

Comparison between MRCP and ERCP in diagnosis of bile duct and pancreatic duct diseases

目的评价磁共振胰胆管成像（MRCP）与经内镜逆行胰胆管造影（ERCP）对胆胰疾病的诊断价值。方法对134例怀疑为胆胰管疾病病人行MRCP，并与58例ERCP比较，所有病例均经手术病理证实。结果134例MRCP均获成功，在行ERCP中54例成功，4例失败者改行PTC检查成功。MRCP和ERCP总的诊断准确率分别为90．3％和88．9％。结论MRCP对胆胰系统疾病中恶性梗阻所致的梗阻性黄疸诊断准确性较高，对胆总管、肝内胆管较小结石的诊断不如ERCP敏感及准确，而且不能治疗，提示MRCP和ERCP各有优越点，二者合理应用可提高胆胰系统疾病的诊断符合率。

Objective To determine the value of magnetic resonance cholangiopancreatography （MRCP） and endoscopic retrograde cholangiopancreatography （ERCP） in the diagnosis of bile duct and pancreatic tract disease. Methods The data of 134 patients with suspected pancreatieobiliary diseases undergoing MRCP were compared with those of 58 receiving ERCP. All patients were confirmed by operation or pathology. Results All the 134 patients underwent MRCP successfully. Four patients failed in ERCP underwent percutaneous transhepatic eholangiography （PTC）. The overall concordance rates of MRCP and ERCP were 90.3% and 88.9%, respectively. Conclusion MRCP has a noninvasive diagnostic modality capable of producing high-quality imagines of bile duct and pancreatic tract. MRCP has a high sensitivity and specificity in the evaluation of the bile duct and pancreatic tract. The efficacy of MRCP is sufficient to justify its use in the diagnosis of bile duct and pancreatic tract diseases, but not to replace ERCP.