B超、腹部CT联合诊断肝外胆管结石的临床价值

Clinical Value of Ultrasound Combined with Abdominal CT in the Diagnosis of Extrahepatic Bile Duct Stones

目的探讨B超、腹部CT联合诊断肝外胆管结石的临床价值。方法将我院收治的77例疑似肝外胆管结石患者作为研究对象,均于术前进行B超和腹部CT检查,且以手术结果为金标准,比较B超、腹部CT及其联合检查对肝外胆管结石诊断价值。结果 77例患者中肝外胆管结石、肝内胆管结石、未见结石例数分别为52例、5例、20例。B超诊断与手术相符者40例,腹部CT诊断与手术相符者42例。B超诊断肝外胆管结石灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为76.92%、64.00%、72.73%、81.63%和57.14%,腹部CT诊断肝外胆管结石灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为80.77%、68.00%、76.62%、84.00%和62.96%,B超联合腹部CT诊断肝外胆管结石灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为94.23%、92.00%、93.51%、96.08%和88.46%,联合检查对肝外胆管结石诊断效能高于单独超声检查和单独腹部CT检查(P<0.05)。结论B超联合腹部CT对肝外胆管结石诊断效能优于单独超声检查和单独腹部CT检查。

Objective To investigate clinical value of ultrasound combined with abdominal CT in the diagnosis of extrahepatic bile duct stones.Methods 77 patients with suspected extrahepatic bile duct stones in our hospital were selected in the study.All patients were examined by B-ultrasound and abdominal CT examination before operation.Taking the operation results as the gold standard.The diagnostic value of extrahepatic bile duct stones by B-ultrasound,abdominal CT and their joint examination were compared.Results Of the 77 patients,the amount of extrahepatic bile duct stones,intrahepatic bile duct stones,and no stones was 52 cases,5 cases,and 20 cases,the patients diagnosed by B-ultrasound consistent with surgery was 40,and the patients diagnosed abdominal CT consistent with surgery was 42.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of extrahepatic bile duct stones by B-ultrasound diagnosis were 76.92%,64.00%,72.73%,81.63%and 57.14%,respectively.The values were 80.77%,68.00%,76.62%,84.00%and 62.96%by abdominal CT diagnosis,respectively.The values were 94.23%,92.00%,93.51%,96.08%,and 88.46%,respectively by B-ultrasound combined with abdominal CT.The diagnosis effect of extrahepatic bile duct stones by the combined diagnosis was more effective than ultrasound and abdominal CT alone(P<0.05).Conclusion B-ultrasound combined with abdominal CT is superior to ultrasound and single abdominal CT in the diagnosis of extrahepatic bile duct stones.