CT与MRCP在胆道系统结石诊断中的应用价值分析

Value Analysis of CT and MRCP in the Diagnosis of Biliary Calculi

目的:观察腹部CT与MRI胆管成像(MRCP)在肝内胆管结石诊断中的应用效果。方法:回顾性选取本院2018年1月到2022年2月期间收治的60例疑似肝内胆管结石患者进行本次研究,患者均接受腹部CT和MRCP诊断,以后续手术结果为诊断金标准,比较分析单纯CT诊断、单纯MRCP诊断、CT联合MRCP诊断与手术结果的一致性,统计学方法采用卡方检验。结果:60例疑似肝内胆管结石患者经手术结果显示,46例确诊为肝内胆管结石,另外14例排除肝内胆管结石的可能性;采用CT诊断肝内胆管结石的敏感度为80.43%,特异度为71.43%,诊断准确度为78.33%;采用MRCP诊断肝内胆管结石的敏感度为91.30%,特异度为85.71%,诊断准确度为90.00%;采用CT联合MRCP诊断肝内胆管结石的敏感度为97.83%,特异度为92.86%,诊断准确度为96.67%。其中,单纯的CT检查与手术诊断结果的差异具有统计学意义(P<0.05);单纯的MRCP检查与手术结果诊断肝内胆管结石相比,差异具有统计学意义(P<0.05);而CT联合MRCP检查与手术结果诊断肝内胆管结石相比,差异无统计学意义(P>0.05)。结论:在诊断疑似肝内胆管结石的患者中,联合使用CT与MRCP较单纯使用CT、MRCP的诊断价值更高,建议对于临床条件适宜的患者采用。

Objective:To observe the application effect of abdominal CT and MRI cholangiography(MRCP)in the diagnosis of intrahepatic bile duct stones.Methods:Sixty patients with suspected intrahepatic bile duct stones admitted to our hospital from January 2018 to February 2022 were retrospectively selected for this study.All patients were diagnosed by abdominal CT and MRCP.The results of follow-up operations were used as the diagnostic gold standard for comparative analysis.The consistency of CT diagnosis alone,MRCP diagnosis alone,CT combined MRCP diagnosis and surgical results,the statistical method used Chi-square test.Results:The surgical results of 60 patients with suspected intrahepatic bile duct stones showed that 46 patients were diagnosed with intrahepatic bile duct stones,and the other 14 patients ruled out the possibility of intrahepatic bile duct stones;the sensitivity of CT for the diagnosis of intrahepatic bile duct stones was 80.43%.The specificity was 71.43%,and the diagnostic accuracy was 78.33%;the sensitivity of MRCP for the diagnosis of intrahepatic bile duct stones was 91.30%,the specificity was 85.71%,and the diagnostic accuracy was 90.00%;CT combined with MRCP was used to diagnose intrahepatic bile duct stones.The sensitivity was 97.83%,the specificity was 92.86%,and the diagnostic accuracy was 96.67%.Among them,the results of simple CT examination and surgical diagnosis were statistically significant(P<0.05);compared with pure MRCP examination and surgical results in the diagnosis of intrahepatic bile duct stones,the difference was statistically significant(P<0.05);and CT combined with MRCP examination Compared with the surgical results in the diagnosis of intrahepatic bile duct stones,the difference was not statistically significant(P>0.05).Conclusion:In the diagnosis of suspected intrahepatic bile duct stones,the combined use of CT and MRCP has a higher diagnostic value than the use of CT and MRCP alone,and it is recommended for patients with suitable clinical conditions.