超声仿真内镜技术Fly—Thru评估胆道梗阻程度及诊断胆道疾病的临床研究

A clinical study of virtual endoscopy ultrasound Fly-Thru in the diagnosis of obstructive degree and nature for obstructive bile duct diseases

目的探讨超声仿真内镜技术Fly-Thru在评估胆道梗阻程度及诊断胆道疾病中的临床作用。方法采集并重建100例胆道梗阻性疾病患者Fly-Thru图像，由两位不同年资超声医师分析Fly-Thru图像，评价Fly-Thru技术对胆道梗阻程度、二维超声结合Fly-Thru技术对胆道梗阻性疾病性质的诊断能力。结果Fly-Thru对梗阻程度判断的准确率为70．59％，敏感性为89．2％（95％CI74．6％～96．9％），二维超声结合Fly-Thru图像可将对病变性质的诊断准确率从80％提高至84％（x2=21．503，P=0．000）。对胆总管病变，二维超声诊断准确率为77．2%，结合Fly-Thru的准确率提高至86．0％（x2=14．399，P=0．001）。结论超声仿真内镜技术Fly-Thru仅能在一定程度上显示胆道梗阻程度，但二维超声结合Fly-Thru可提高对胆总管病变的诊断能力。

Objective To investigate the utility of virtual endoscopy ultrasound Fly-Thru in the diagnosis of obstructive bile duct diseases. Methods One-hundred patients with obstructed bile duct diseases underwent Fly-Thru examination. All Fly-Thru images were reviewed by two radiologists with different experience. The capabilities of Fly-Thru for bile duct obstructive degree evaluation and distinguishing malignant lesion from benign one were assessed respectively. Results The accuracy and sensitivity of Fly-Thru image in obstruction degree evaluation were 70.59% and 89.2% （95 %CI 74,6% - 96.9% ）. The diagnosis accuracy of 2DUS for lesion characteristics increased from 80% to 84%, accompany with Fly-Thru images, especially for lesions in common bile duct from 77.2 % to 86.0 % （X2 = 14. 399, P = 0.001）. Conclusions The virtual endoscopy ultrasound Fly-Thru is only partly capable to display the obstructed degree of some bile ducts, but it can improve the diagnostic accuracy of common bile duct diseases.