肝胆管结石病影像学诊断方法的效果评价

Diagnosis effect of imaging checks for hepatolithiasis

目的探讨B型超声扫描(B-US)、电子计算机断层扫描(CT)、磁共振成像(MRI)、内镜逆行胰胆造影(ERCP)等检查方法对肝胆管结石病的诊断效果。方法回顾性分析2000年1月至2015年1月529例肝胆管结石病患者的临床资料,统计分析B-US、CT、MRI和ERCP这4种影像学检查方法以及B-US+CT、B-US+MRI、B-US+ERCP对529例肝胆管结石病在肝内胆管结石、肝叶病变、胆管狭窄、胆管扩张等方面的敏感性差异。结果 B-US和MRI对结石的敏感性最高,CT和MRI对肝叶病变的敏感性最高,B-US和MRI对胆管扩张的敏感性最高,ERCP和MRI对胆管狭窄的敏感性最高,B-US与MRI联合应用最适合肝胆管结石病的全面诊断。结论 B-US与MRI联合应用是肝胆管结石病术前最佳的影像学检查方式。

Objective To explore the diagnosis effect of B-US、CT、MRI and ERCP for hepatolithiasis. Methods Clinical data of 529 patients with hepatolithiasis who were admitted to hospital from January 2000 to January 2015 were retrospectively analyzed. The susceptibility differences in intrahepatic stone,hepatic lobe lesion,stenosis and cholangiectasis of bile duct were statistically analyzed through different imaging checks,namely B-US,CT,MRI,ERCP,B-US ＋ CT,B-US ＋ MRI and B-US ＋ ERCP. Results B-US and MRI showed highest sensitivity for intrahepatic stone. CT and MRI showed highest sensitivity for hepatic lobe lesion. B-US and MRI showed the highest sensitivity for cholangiectasis of bile duct. ERCP and MRI showed highest sensitivity for bile duct stenosis. The combined application of B-US and MRI is comprehensive diagnosis for hepatolithiasis. Conclusion B-US associated with MRI is the best methods of imaging check befor hepatolithiasis surgery.