探析腹部CT与磁共振胰胆管成像对肝胆外结石患者的临床诊断效果

Exploring the Clinical Diagnostic Effect of Abdominal CT and Magnetic Resonanced Cholangio-pancreatography in Patients with Extrahepatic and Biliary Calculi

目的分析肝胆外结石患者采用腹部CT与磁共振胰胆管成像检查后的临床诊断效果。方法选择2021年1月—2023年1月胶州市心理康复医院收治的80例高度疑似肝胆外结石患者,以手术病理检查作为肝胆外结石诊断的金标准,均先进行腹部CT检查,后进行磁共振胰胆管成像(magnetic resonanced cholangio-pancreatography,MRCP)检查,比较不同检查方法的阳性检查率、符合率以及诊断效能。结果经手术病理检查确诊76例患者为肝胆外结石,腹部CT+MRCP阳性检查率显著高于腹部CT、MRCP检查。经手术病理检查确诊原发性结石55例、继发性结石21例,直径>9 cm结石32例、直径≤9 cm结石44例,腹部CT+MRCP检查结果符合率显著高于腹部CT、MRCP检查,差异有统计学意义(P<0.05)。腹部CT+MRCP检查敏感性、特异性、准确率均显著高于腹部CT、MRCP检查,差异有统计学意义(P<0.05)。结论腹部CT和MRCP联合检查方式对肝外胆管结石的检出率更高,更利于患者病情的确诊,临床应用价值更高。

Objective To analyze the clinical diagnostic effect of patients with extrahepatic and biliary stones after using abdominal CT and magnetic resonanced cholangio-pancreatography.Methods A total of 80 patients with highly suspected extrinsic hepatolithiasis admitted to Jiaozhou Psychological Rehabilitation Hospital from January 2021 to January 2023 were selected,and surgical pathologic examination was used as the gold standard for the diagnosis of extrinsic hepatolithiasis.Abdominal CT scan was performed first,followed by magnetic resonanced cholangio-pancreatography(MRCP).The positive rate,coincidence rate and diagnostic efficiency of different examination methods were compared.Results The operation and pathological examination confirmed 76 patients with extrinsic hepatobiliary stones.The positive rate of abdominal CT+MRCP was significantly higher than that of abdominal CT and MRCP.Surgical and pathological examination confirmed 55 cases of primary stones,21 cases of secondary stones,32 cases of diameter>9 cm stones,44 cases of diameter≤9 cm stones.The coincidence rate of abdominal CT+MRCP examination results was significantly higher than that of abdominal CT and MRCP examination,and the difference was statistically significant(P<0.05).The sensitivity,specificity and accuracy of abdominal CT+MRCP were significantly higher than those of abdominal CT and MRCP,the difference was statistically significant(P<0.05).Conclusion The detection rate of extrahepatic and biliary stones is higher in the combination of abdominal CT and MRCP examination,which is more conducive to the diagnosis of patients'conditions and has higher clinical application value.