彩超联合MRI对胆道梗阻定位和定性诊断的临床应用

Application of Color Doppler Ultrasound Combined with MRI in the Diagnosis of Biliary Obstruction

目的研究彩超联合MRI对胆道梗阻定位和定性诊断的临床应用。方法回顾性分析2016年1月至2019年1月宜昌市夷陵医院和国药葛洲坝中心医院收治的经病理或手术确诊的246例胆道梗阻患者临床病案资料,所有患者术前均行彩超(CDUS)、磁共振(MRI)检查,以病理或手术诊断结果为“金标准”,比较CDUS、MRI、CDUS联合MRI对胆道梗阻定位和定性的价值。结果三种诊断方法中,CDUS对胆道梗阻定位诊断准确率最低,为96.75%,MRI对胆道梗阻定位诊断准确率为98.37%,CDUS+MRI对胆道梗阻定位诊断准确率最高,为99.19%,但三者比较差异无统计学意义;三种诊断方法对良性病变的诊断中,CDUS诊断准确率最低,为85.43%,MRI诊断准确率为92.05%,CDUS+MRI诊断准确率最高,为95.36%,比较差异有统计学意义(P<0.05);三种诊断方法对恶性病变的诊断中,CDUS诊断准确率最低,为82.11%,MRI诊断准确率为91.58%,CDUS+MRI诊断准确率最高,为94.74%,比较差异有统计学意义(P<0.05)。结论彩超联合MRI在胆道梗阻的定位和定性诊断中具有较高准确率,尤其在定性诊断中具有较高价值,值得推广使用。

Objective To investigate the application of color Doppler ultrasound(CDUS)combined with magnetic resonance imaging(MRI)in the diagnosis of biliary obstruction.Methods Clinical data of 246 patients with pathologically or surgery confirmed biliary tract obstruction in Yichang Yiling Hospital and Sinopharm Gezhouba Central Hospital from January 2016 to January 2019 were retrospectively analyzed.All patients underwent CDUS and MRI examinations before surgery,then the value of three methods in the localization and qualitative analysis of biliary obstruction was compared based on the pathological or surgical results.Results The accuracy of CDUS,MRI,and CDUS+MRI in the diagnosis of biliary obstruction was 96.75%,98.37%,and 99.19%,respectively,with no statistical difference(P>0.05).The diagnostic accuracy of CDUS,MRI,and CDUS+MRI for benign lesions was 85.43%,92.05%,and 95.36%,with statistic difference(P<0.05).The diagnostic accuracy of CDUS,MRI,and CDUS+MRI for malignant lesions was 82.11%,91.58%,and 94.74%,with statistic difference(P<0.05).Conclusion Color ultrasound combined with MRI has high accuracy in the localization and qualitative diagnosis of biliary tract obstruction,especially in the qualitative diagnosis,which is worth promotion.