腹部CT及核磁胆胰管成像用于肝外胆管结石诊断的价值

The Value of Abdominal CT and Magnetic Cholangiopancreatography in the Diagnosis of Extrahepatic Bile Duct Stones

目的探究应用腹部CT及核磁胆胰管成像检测在肝外胆管结石诊断中的临床价值。方法选取2019年9月-2020年9月我院收诊的112例疑似肝外胆管结石患者为研究对象,均实施腹部CT及核磁胆胰管成像检查,比较两种检查方法对结石直径≤8mm的检出率、操作耗时以及与病理结果的符合情况。结果112例患者中,108例确诊为肝外胆结石,其中单纯肝外胆管结石患者32例、合并肝内胆管结石患者21例、合并胆囊结石患者55例;腹部CT检查符合术后病理诊断的88例,核磁胆胰管成像检查符合术后病理诊断的104例;核磁胆胰管成像技术的阳性检出率、灵敏度、特异度、诊断符合率均高于腹部CT,差异有统计学意义(P<0.05);核磁胰胆管成像检查对结石直径≤8 mm的检出率高于腹部CT检查,差异有统计学意义(P<0.05);核磁胰胆管成像检查平均用时长于腹部CT检查,差异有统计学意义(P<0.05)。结论在肝外胆管结石的诊断中,应用核磁胆胰管成像检查的诊断敏感度、特异度、符合率高于腹部CT,而且能够提升小结石的检出率。但核磁胆胰管成像在检查操作中耗费的时间较腹部CT略长,其整体优势显著。

Objective To explore the clinical value of the application of abdominal CT and magnetic cholangiopancreatography in the diagnosis of extrahepatic bile duct stones.Methods A total of 112 patients with suspected extrahepatic bile duct stones admitted to our hospital from September 2019 to September 2020 were selected as the research subjects,and all of them underwent abdominal CT and NMR cholangiopancreatography.The detection rate of stones with diameter≤8 mm,the time-consuming operation and the conformity with the pathological results of the two inspection methods were compared.Results 108 of 112 patients were diagnosed with extrahepatic gallstones,including 32 patients with simple extrahepatic bile duct stones,21 patients with intrahepatic bile duct stones,and 55 patients with gallbladder stones.Abdominal CT examination was consistent with postoperative pathological diagnosis in 88 cases,and nuclear magnetic cholangiopancreatography examination in 104 cases was consistent with postoperative pathological diagnosis;The positive detection rate,sensitivity,specificity,and diagnostic coincidence rate of NMR cholangiopancreatography were higher than that of abdominal CT,the difference was statistically significant(P<0.05);The detection rate of MR cholangiopancreatography for calculus diameter≤8 mm was higher than that of abdominal CT examination,the difference was statistically significant(P<0.05);The average time of NMR cholangiopancreatography examination was longer than that of abdominal CT examination,the difference was statistically significant(P<0.05).Conclusion In the diagnosis of extrahepatic bile duct stones,the diagnostic sensitivity,specificity,and coincidence rate of MR cholangiopancreatography is higher than that of abdominal CT,and it can improve the detection rate of small stones.However,NMR imaging of the cholangiopancreatography takes slightly longer time than abdominal CT,and its overall advantage is significant.