低场强MRCP对B超检查阴性的胆总管结石的诊断意义

Diagnostic value of MRCP in bile duct stone revealed as negative under B-ultrasound examination

目的:探讨低场强核磁共振胰胆管成像检查(Magnetic resonance cholangiopancreatography,MRCP)对于B超检查阴性的胆总管结石的临床诊断意义,为术前判断术中是否需行胆管切开探查及术后胆管残余结石诊断提供临床指导价值。方法:对43例B超检查未发现胆总管结石,但有胆总管扩张或/和伴有肝功能异常者常规行低场强核磁共振胰胆管成像检查(MRCP)。结果:43例患者MRCP检查提示:21例发现胆总管有结石,22例检查未发现结石。所有患者均行术中探查,22例探查发现有胆总管结石,1例术中漏诊,术后残余结石位于乳头部行ERCP检查确诊,后行EST取石术。MRCP诊断准确率为91.3%(21/23)。结论:低场强核磁共振胰胆管成像MRCP检查对胆管结石诊断的敏感性及特异性均较高,有较好的临床应用指导价值。

Objective： To investigate the diagnostic value of magnetic resonance cholangiopancreatography（MRCP） in diagnosis of bile duct stones that were negative under B-ultrasound.Methods： Forty-three cases that had dilated common bile duct or/and abnormal liver function but were revealed as being free of bile duct stones underwent MRCP examination.Results： Under MRCP,common bile duct stones were positive in 21 cases,but negative in the other 22 cases.While according to intraoperative exploration,there were 22 cases of common bile duct stones all together.Postoperative residual stones was observed in the papilla in one case and was extracted with EST lithotomy.The diagnostic accuracy of MRCP was 91.3%（21/23）.Conclusion： The sensitivity and specificity of MRCP detection in the diagnosis of bile duct stones are higher showing good clinical value.