腹部CT与磁共振胰胆管成像在肝外胆管结石诊断中的应用价值

Application Value of Abdominal CT and Magnetic Resonance Cholangiopancreatography in the Diagnosis of Extrahepatic Bile Duct Stones

目的:分析腹部CT与磁共振胰胆管成像在肝外胆管结石诊断中的应用价值。方法:回顾性分析2020年1月—2022年5月郑州市第三人民医院接受诊治的70例疑似肝外胆管结石患者临床资料,对所有患者均进行腹部CT与磁共振胰胆管成像扫描诊断,以手术病理结果为金标准,统计两种诊断方式的诊断效能,统计两种诊断方式对直径<8 mm结石的检出率,记录检查所耗用的时间。结果:以手术病理结果为金标准,70例疑似患者中阳性和阴性分别为67例和3例,腹部CT与磁共振胰胆管成像诊断的符合率分别为53例(75.71%)和65例(92.86%),在诊断效能方面,两种诊断方式的特异度比较,差异无统计学意义(χ^(2)=0,P>0.05);磁共振胰胆管成像诊断的敏感度、准确率均较腹部CT高,差异有统计学意义(χ^(2)=8.873、8.776,P<0.05);磁共振胰胆管成像对直径<8 mm结石检出率较腹部CT高,但是所用的检查时间稍长,差异有统计学意义(χ^(2)=18.746;t=2.613,P<0.05)。结论:临床上对肝外胆管结石患者实施诊断时,应用腹部CT与磁共振胰胆管成像诊断均可,但是相比较而言,磁共振胰胆管成像诊断准确率更高,可为临床治疗提供可靠的指导依据。

Objective:To analyze the application value of abdominal CT and magnetic resonance cholangiopancreatography in the diagnosis of extrahepatic bile duct stones.Methods:70 patients with suspected extrahepatic bile duct stones receiving relevant diagnosis admitted to the hospital from January 2020 to May 2022 were retrospectively analyzed.All patients underwent abdominal CT and magnetic resonance cholangiopancreatography scans for diagnosis.The surgical and pathological results was took as the gold standard,the diagnostic efficacy of the two diagnostic methods was calculated,the detection rate of stones with a diameter of<8 mm using the two diagnostic methods was calculated,the time spent on the inspection was recorded.Results:Using surgical and pathological results as the gold standard,67 out of 70 suspected patients were positive and 3 were negative,respectively.The coincidence rates between abdominal CT and magnetic resonance cholangiopancreatography were 53(75.71%)and 65(92.86%),respectively.In terms of diagnostic efficacy,the specificity of the two diagnostic methods was compared,with no statistically significant difference(χ^(2)=0,P>0.05).But the sensitivity and accuracy of magnetic resonance cholangiopancreatography were higher than those of abdominal CT,with statistically significant difference(χ^(2)=8.873,8.776;P<0.05).Magnetic resonance cholangiopancreatography has a higher detection rate for stones with a diameter of<8 mm compared to abdominal CT,but the examination time used is slightly longer(χ^(2)=18.746;t=2.613,P<0.05).Conclusion:When diagnosing patients with extrahepatic bile duct stones in clinical practice,both abdominal CT and magnetic resonance cholangiopancreatography can be used for diagnosis.However,compared to other methods,magnetic resonance cholangiopancreatography has a higher diagnostic accuracy and can provide reliable guidance for clinical treatment.