探讨增强CT联合MRI在胆管良恶性狭窄鉴别诊断中的价值分析

The Value of Enhanced CT Combined with MRI in Differential Diagnosis of Benign and Malignant Biliary Strictures

目的探讨增强CT检查联合MRI在胆管良恶性狭窄鉴别诊断中的价值。方法选取2015年3月-2016年6月来我院就诊的68例胆道狭窄患者作为研究对象,患者均采用MRI检查与增强CT检查,以手术病理结果为参考标准,观察两种检查方法诊断结果,对比两种检查方法诊断效能,创建不同检查法受试工作特征曲线(ROC曲线),计算曲线下面积(AUC)。结果 MRI检查诊断准确率为89.71%,误诊率为10.81%,敏感度为90.32%,特异度为89.19%。增强CT检查诊断准确率为95.59%,误诊率为2.86%,灵敏度为93.75%,特异度为94.44%。MRI联合增强CT检查法准确率、敏感度、特异度、AUC值(0.876)均高于单项检查(0.751,0.697),除准确率外差异均有显著性(P<0.05),误诊率低于单项检查法,差异无显著性(P>0.05)。结论增强CT与MRI均为胆管狭窄病变诊断的有效方法,二者联合使用诊断效能较好,具有一定的临床参考价值。

Objective To investigate the value of enhanced CT combined with MRI in the differential diagnosis of benign and malignancy biliary strictures.Methods A total of 68 cases of patients with biliary stricture from March 2015 to June 2016 to our hospital were selected as the research object,all patients underwent MRI and enhanced CT examination,with surgical pathology results as the reference standard,and observe these two methodss to check the results of the inspection and compared the diagnostic rate of two kinds of methods,and to create different test subjects working characteristic curve(ROC curve),calculate the area under the curve(AUC).Results The diagnostic accuracy of MRI was 89.71%,the misdiagnosis rate was 10.81%and the sensitivity was 90.32%,and the specificity was 89.19%.The diagnostic accuracy of enhanced CT was 95.59%,the misdiagnosis rate was 2.86%,the sensitivity was 93.75%,and the specificity was 94.44%.The accuracy,sensitivity,speciality degree,AUC value(0.876)of MRI combined with enhanced CT were higher than that of single check(0.751,0.751),except the accuracy differences were significant(P<0.05),the misdiagnosis rate is lower than that of single test,there was no significant difference(P >0.05).Conclusion Enhanced CT and MRI are effective methods for the diagnosis of bile duct stenosis,and the combination of the two methods has good diagnostic efficacy and has certain clinical reference value.