多层螺旋CT联合MRI对胆总管结石的诊断价值

Diagnostic value of multi-slice spiral CT combined with MRI in choledocholithiasis

目的探讨多层螺旋CT联合MRI对胆总管结石的诊断价值。方法选取本院2020年1月至2021年5月收治的122例疑似胆总管结石患者作为研究对象,分别开展多层螺旋CT检查、MRI检查及联合检查,将手术病理检查结果作为诊断金标准,比较不同检查方法对胆总管结石的诊断有效率、灵敏度、特异度、阳性预测值和阴性预测值。结果病理检查结果显示胆总管结石阳性102例,阴性20例;联合检查结果显示胆总管结石阳性100例,诊断准确率为81.97%,与病理检查结果比较差异无统计学意义。多层螺旋CT检查结果显示阳性81例,诊断准确率为66.39%;MRI检查结果显示阳性84例,诊断准确率为68.85%;联合检查对胆总管结石诊断准确率、灵敏度、特异度、阳性预测值及阴性预测值高于多层螺旋CT和MRI单独检查,差异有统计学意义(P<0.05);多层螺旋CT和MRI单独检查的准确率、灵敏度、特异度、阳性预测值及阴性预测值比较差异无统计学意义。结论多层螺旋CT联合MRI诊断胆总管结石效果确切,值得临床推广应用。

Objective To investigate the diagnostic value of multi-slice spiral CT combined magnetic resonance imaging technology(MRI)on choledocholithiasis.Methods A total of 122 patients who were suspected of the suspected choledocholithiasis from January 2020 to May 2021 were selected as the research subjects,the patients conducted multi-slice spiral CT examination,MRI examination,and two joint inspections.Surgical pathological examination results were used as diagnostic gold standards,and the diagnosis of choledocholithiasis were compared to different inspection methods.Results Pathological examination showed that 102 cases of choledocholithiasis were positive and 20 were negative.The results of combined examination showed that 100 cases of choledocholithiasis were positive,and the diagnostic accuracy was 81.97%,which was not statistically significant compared with the pathological examination results.The results of multi-slice spiral CT were positive in 81 cases,the diagnostic accuracy was 66.39%;MRI showed positive results in 84 cases,the diagnostic accuracy rate was 68.85%;the diagnostic accuracy,sensitivity,specificity,positive and negative predictive values of combined examination were higher than those of multi-slice spiral CT and MRI alone,and the differences were statistically significant(P<0.05);there were no significant differences in the accuracy,sensitivity,specificity,positive and negative predictive values between multi-slice spiral CT and MRI alone.Conclusion The diagnosis of choledocholithiasis by multi-slice spiral CT combined with MRI is effective,and worthy of clinical promotion and application.