MSCT、MRCP、MRI结合MRCP在诊断胆道梗阻性疾病中的应用比较

Comparison of MSCT, MRCP and the Combination of MRI and MRCP in the Diagnosis of Biliary Obstructive Disease

目的比较多层螺旋CT(MSCT)、磁共振胰胆管造影术(MRCP)、MRI结合MRCP3种影像学检查方法在诊断胆道梗阻性疾病中的应用价值。方法回顾性分析154例经手术病理或镜下逆行胰胆管造影(ERCP)检查证实的胆道梗阻性疾病患者的MSCT、MRCP、MRI平扫资料,比较MSCT、MRCP、MRI结合MRCP的诊断结果,并与手术病理结果对照。结果 MSCT、MRCP、MRI结合MRCP对胆道梗阻性疾病的定位诊断准确率分别为88.3%、92.9%、95.5%,对良性梗阻的定性诊断准确率分别为87.8%、92.7%、96.3%,对恶性梗阻的定性诊断准确率分别为95.8%、87.5%、97.2%,总的定性诊断准确率分别为91.6%、90.3%、96.8%。结论几种检查方法各有优缺点,在临床上多种方法联合应用对判断胆道梗阻性疾病的病因十分重要。

Objective To compare the application of multi-slice CT（MSCT）, magnetic resonance cholangiopancreatography（MRCP）, and the combination of MRI and MRCP in the diagnosis of biliary obstructive disease. Methods Retrospective analysis of MSCT, MRCP and MRI images was performed on 154 patients who were confirmed as biliary obstructive disease by surgery and pathology or endoscopic retrograde cholangiopancreatography（ERCP）. Then the diagnosed results of MSCT, MRCP, MRI combined with MRCP were compared with each other as well as pathology results. Results The accuracies of MSCT, MRCP, MRI combined with MRCP in the localization diagnosis of biliary obstructive disease were 88.3%, 92.9% and 95.5%, respectively. The accuracies of MSCT, MRCP, MRI combined with MRCP in the qualitative diagnosis of benign obstruction were 87.8%, 92.7% and 96.3%, respectively; in the qualitative diagnosis of malignant obstruction were 95.8%, 87.5% and 97.2%, respectively; and the total accuracies of MSCT, MRCP, MRI combined with MRCP in qualitative diagnosis were 91.6%, 90.3% and 96.8%, respectively. Conclusion As each examination method has its advantages and disadvantages, the combined application of various methods in clinical is very important to identify the causes of biliary obstructive disease.