术前MRCP与LC术中胆道造影诊断胆囊结石合并可疑胆总管结石的临床价值比较

Preoperative MRCP versus intraoperative cholangiography in laparoscopic cholecystectomy:a clinical comparison of diagnosis effects on cholecystolithiasis combined potential choledocholithiasis

目的比较术前磁共振胆胰管成像(MRCP)与腹腔镜胆囊切除术(LC术)中胆道造影(IOC)诊断胆囊结石合并可疑胆总管结石的临床价值。方法回顾分析2012年1月至2014年12月该院对胆囊结石合并可疑胆总管结石的272例患者MRCP及LC-IOC的临床资料。结果 MRCP与LC-IOC诊断结果差异无统计学意义(P=0.267);与LC-IOC比较,MRCP诊断胆囊结石合并可疑胆总管结石的一致率为95.22%、敏感性为89.41%、特异性为97.86%;两种方法的吻合系数为Kappa=0.887;ROC曲线下面积为0.936,吻合度强。结论 MRCP能在术前简便、准确、无创地诊断胆囊结石患者是否合并胆总管结石,从而尽量避免并发症发生。

Objective To compare the diagnosis values between preoperative MRCP and intraoperative cholangiography in laparoscopic cholecystectomy with cholecystolithiasis combined potential choledocholithiasis.Methods Clinical data of 272 patients who underwent MRCP and LC-IOC for cholecystolithiasis combined potential choledocholithiasis from January 2012 to December2014in our hospital were analyzed retrospectively.Results The diagnosis values between MRCP and LC-IOC were not statistically different（P=0.267）.Compared with LC-IOC,the consistency rate of MRCP was 95.22%,Sen was 89.41%,Spe was 97.86%,Kappa=0.887.The area under the ROC curve was 0.936.Conclusion Cholecystolithiasis combined choledocholithiasis might be diagnosed conveniently and accurately by preoperative MRCP with no invasion to trying to avoid complications.