MRI联合MRCP在胆道梗阻性疾病诊断中的应用价值

Value of topical and qualitative diagnosis of biliary obstruction diseases based on MRI combined with MRCP

目的 探究MRI及MRCP在胆道梗阻性疾病定位和定性诊断的应用价值。方法 回顾性分析2017年11月至2019年11月在上海中医药大学附属岳阳中西医结合医院经手术病理或临床证实的72例胆道梗阻性疾病患者的临床资料,所有患者均行MRI及MRCP检查,其中42例加行CT检查,对不同影像学检查结果进行对比分析。结果 MRI联合MRCP、MRI、CT检查的定位诊断准确率分别为100%(72/72)、94.4%(68/72)、78.6%(33/42),定性诊断准确率分别为95.8%(69/72)、86.1%(62/72)、66.7%(28/42)。上述3种影像学检查均做的42例中,MRI联合MRCP检查较CT检查的定位诊断[100%(42/42) vs 78.6%(33/42),χ^(2)=10.080,P<0.05]和定性诊断[90.5%(38/42) vs 66.7%(28/42),χ^(2)=7.071,P<0.05]的准确率差异均有统计学意义,MRI联合MRCP与MRI、MRI与CT检查比较,定位诊断和定性诊断的准确率差异均无统计学意义(P>0.05)。结论 MRI联合MRCP可显著提高对胆道梗阻性病变的检出率和确诊率。

Objective To explore the value of MRI and MRCP in topical and qualitative diagnosis of biliary obstructive diseases.Methods The clinical data of 72 patients with biliary obstructive diseases proved pathologically or clinically in Yueyang Hospital of Integrated Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from Nov.2017 to Nov.2019 were retrospectively analyzed.All patients underwent MRI and MRCP examinations,and 42 of them underwent additional CT examinations.The results of the different imaging examinations were compared.Results The topical diagnosis accuracy rates were found to be 100%(72/72) for MRI combined with MRCP,94.4%(68/72) for MRI,and 78.6%(33/42) for CT.Similarly,the qualitative diagnosis accuracy rates was 95.8%(69/72) for MRI combined with MRCP,86.1%(62/72) for MRI,and 66.7%(28/42) for CT.Among the 42 patients who underwent all 3 imaging examinations,there were significant differences in both the topical diagnosis accuracy rate [100%(42/42) vs 78.6%(33/42),χ^(2)=10.080,P<0.05] and the qualitative diagnosis accuracy rate [90.5%(38/42) vs 66.7%(28/42),χ^(2)=7.071,P<0.05] between MRI combined with MRCP and CT.However,there was no significant difference in topical or qualitative diagnosis accuracy rate between MRI+MRCP and MRI,MRI and CT examinations(P>0.05).Conclusion MRI combined with MRCP can improve the detection rate and diagnosis rate of biliary obstructive diseases significantly.