超声内镜和腹部超声诊断胆管结石的效能对比

Comparison of the efficacy between endoscopic ultrasonography and abdominal ultrasound in the diagnosis of calculi of bile duct

目的比较超声内镜和腹部超声诊断胆管结石的效能。方法回顾性分析30例疑似胆管结石患者的临床资料,所有患者均行超声内镜、腹部超声,以及经内镜逆行胰胆管造影/内镜下十二指肠乳头括约肌切开术。以经内镜逆行胰胆管造影/内镜下十二指肠乳头括约肌切开术诊断胆管结石为金标准,比较超声内镜、腹部超声诊断胆管结石的效能。结果超声内镜诊断胆管结石的准确度高于腹部超声法(P<0.05)。超声内镜诊断胆管结石的结果与金标准存在关联(P<0.05),但腹部超声诊断胆管结石的结果与金标准无关联(P>0.05)。与金标准相比,超声内镜、腹部超声诊断胆管结石的阳性结果差异均无统计学意义(均P>0.05)。超声内镜诊断不同部位(胆总管末端、胆总管以上、胆总管中下段)、不同大小(直径≤0.5 cm、0.5~1.0 cm、>1.0 cm)结石的结果与金标准均存在关联(均P<0.05),但腹部超声诊断上述结石的结果与金标准无关联(均P>0.05)。结论超声内镜对胆管结石的诊断效能高于腹部超声,对不同位置、大小的胆管结石的诊断结果均与金标准存在关联,对临床治疗有一定的指导价值。

Objective To compare the efficacy between endoscopic ultrasound and abdominal ultrasound in the diagnosis of calculi of bile duct.Methods The clinical data of 30 patients with suspected calculi of bile duct were retrospectively analyzed,and all patients underwent endoscopic ultrasound,abdominal ultrasound,and endoscopic retrograde cholangiopancreatography/endoscopic duodenal papillary sphincterotomy.With the endoscopic retrograde cholangiopancreatography/endoscopic duodenal papillary sphincterotomy as the gold standard in the diagnosis of calculi of bile duct,the efficacy between endoscopic ultrasonography and abdominal ultrasound in the diagnosis of calculi of bile duct was compared.Results The accuracy of endoscopic ultrasound in the diagnosis of calculi of bile duct was higher than that of abdominal ultrasound(P<0.05).The results of endoscopic ultrasound in the diagnosis of calculi of bile duct were associated with those of the gold standard(P<0.05),while the results of abdominal ultrasound were not(P>0.05).There was no statistically significant difference in the positive result between the gold standard and endoscopic ultrasound or between the gold standard and abdominal ultrasound in the diagnosis of calculi of bile duct(all P>0.05).The results of endoscopic ultrasound in the diagnosis of calculi in different parts(at the end of the common bile duct,above the common bile duct,and at the middle and lower part of the common bile duct)and in different sizes(diameter≤0.5 cm,0.5-1.0 cm,and>1.0 cm)were associated with those of the gold standard(all P<0.05),while the results of abdominal ultrasound were not(all P>0.05).Conclusion Endoscopic ultrasound has higher diagnosis efficacy for calculi of bile duct than abdominal ultrasound,and its diagnostic results of calculi of bile duct in different parts and sizes are associated with the gold standards',which has a certain guiding value for clinical treatment.