多序列MRI和MSCT诊断胆道结石对照研究

The comparative study of multi-sequence MRI and MSCT in the diagnosis of calculus of bile duct

目的对比探讨多序列磁共振成像(MRI)及多层螺旋CT(MSCT)诊断胆道系统结石的价值。方法抽取2011年7月～2012年7月共58例胆道结石病例,均行MSCT平扫和多序列MRI检查,MRI检查序列包括:轴位T2WI、轴位T2WI压脂、轴位T1WI、冠状位T2WI、厚层块MRCP和薄层MRCP。2种检查时间间隔不超过2天,所有病例均经手术和病理证实。按结石所在部位分成肝内胆管结石、上段胆总管结石、下段胆总管结石及胆囊结石进行统计。将MSCT和多序列MRI诊断结果进行对比,应用配对四格表行2检验统计分析。结果共102个部位存在结石,其中胆囊结石30个部位,上段胆总管结石9个部位,下段胆总管结石36个部位,肝内胆管结石27个部位。多序列MRI诊断100个部位存在结石,MSCT诊断66个部位存在结石,多序列MRI诊断正确率为98.03%(100/102),MSCT诊断正确率为64.7%(66/102),二者差异有统计学意义(χ2=40.0,P<0.01)。结论多序列MRI诊断胆道系统结石明显高于MSCT,为外科手术提供可靠的诊断依据。

Objective To evaluate comparatively the value of multi-sequence magnetic resonance imaging （MRI） gnd multislice computed tomography （MSCT） in the diagnosis of bile duct stones. Methods Between July 2011 to July 2012, a total of 58 patients who were diagnosed as cholangiolithiasis were subjucted to unenhanced MSCT and multi-sequence MRI. MRI scan sequences included axial T2WI, axial T2WI-fatsat, axial TlWI, coronal T2 WI, and the examination time interval was not more than 2 days. ＇All the cases were certified by the surgery and pathology results. According to the lo- cations, stones were segmented into the intrahepatic bile duct stones, the superior common bile duct stones, the inferior common bile duct stones and gallbladder stones. A 2 × 2 table for Chi-square test was used for statistics analysis. Results There were 102 segments existing stones, 30 with gallbladder stones, 9 with the superior common bile duct stones, 36 with the inferior common bile duct stones, and 27 with the intrahepatic bile duct stones. One hundred segments were diag- nosed by multi-sequence MRI; sixty-six segments were diagnosed by MSCT. The diagnostic accuracy of multi-sequence MRI and MSCT were 98.03% （100/102） and 64.7% （66/102）, there was significant difference （X2 =40.0, P 〈0.01）. Conclusion Multi-sequence MRI diagnoses of bile duct stones is significantly higher than that of MSCT, and provides a reliable diagnosis for the surgeon.