64排螺旋CT阴性法胰胆管成像与磁共振胰胆管造影在胆道梗阻性疾病中的应用价值

The Application Value of 64-Slice Spiral CT Negative Cholangiopancreatography and Magnetic Resonance Cholangiopancreatography in Diagnosis of Obstructive Biliary Disease

目的探讨64排螺旋CT阴性法胰胆管成像(NCTCP)与磁共振胰胆管造影(MRCP)在胆道梗阻性疾病中的诊断价值。方法 70例同时行NCTCP和MRCP的胆道梗阻性患者,对两种检查法的胆道显示能力进行比较,并与检查结果、临床结果和手术病理结果进行比较分析。结果 NCTCP和MRCP胆管平均显示能力分别为4.17°和4.26°,经Wilocxon符号秩检验,差异无统计学意义(P>0.05);NCTCP和MRCP定性准确率分别为92.9%和87.1%,经Wilocxon符号秩检验,差异无统计学意义(P>0.05);恶性梗阻46例,NCTCP和MRCP定性准确率分别为95.65%(44/46)和86.96%(40/46),两者比较有显著性差异(P<0.05)。结论 NCTCP在胆道显示能力、定位及定性诊断准确率上与MRCP相当,但对于恶性胆道梗阻诊断方面,NCTCP优于MRCP,NCTCP在诊断胆道梗阻性疾病时具有快捷、方便、安全、可靠等优点。

Objective To discuss the diagnostic value of 64-slice N-CTCP and MRCP in obstructive biliary disease.Methods 70 patients with obstructive biliary had both 64-slice N-CTCP and MRCP.The capabilities of the two methods in displaying bile duct were contrasted and analyzed.Diagnosis of the two methods and clinical diagnosis were contrasted and analyzed.Results The average capability of 64-slice NCTCP in displaying bile duct was 4.17° and the average capability of MRCP in displaying bile duct was 4.26°.By Wilcoxon′s Sign Rank Test,the capabilities of the two methods in displaying bile duct were not significantly different（P0.05）.Whereas the accuracy rate of qualitative diagnosis was 92.9% in 64-slice NCTCP and 87.1% in MRCP.By Wilcoxon′s Sign Rank Test,the capabilities of the two methods in displaying bile duct were not significantly different（P0.05）.Of the 46 cases with malignant obstructive jaundice,the accuracy rate of qualitative diagnosis was 95.65%（44/46） in 64-slice NCTCP and 86.96%（40/46）in MRCP.By contrast,there were significant differences（P0.05）.Conclusion 64-slice NCTCP is similar to MRCP in capability in displaying bile duct,the accuracy rate of localization and qualitative diagnosis.However,NCTCP is better than MRCP in diagnosing malignant obstructive jaundice,because NCTCP is efficient,convenient,secure and accurate.