| 摘要: |
| 目的探讨腔内超声（IDUS）、CT和磁共振胰胆管造影（MRCP）和对胆道恶性梗阻的诊断价值。方法回顾性分析53例胆道恶性梗阻患者的IDUS、CT和MRCP检查结果，比较3种影像学检查方法对胆道恶性梗阻的图像特征和诊断情况。结果IDUS、CT和MRCP对胆道恶性梗阻定位诊断准确率分别为65.31%、82.98%和82.93%，差异有统计学意义（P＜0.05）；而定性诊断准确率分别为63.27%、74.47%和75.61%，差异无统计学意义（P＞0.05）。3种影像学检查方法均能显示胆道恶性梗阻的部位、数量和回声/密度/信号特征：CT和MRCP对壶腹癌定位诊断、胰头癌定性诊断均有较高符合率。IDUS对胆管狭窄性质的阴性预测能力明显高于CT和MRCP（P＜0.05）。结论IDUS、CT和MRCP均能清晰显示胆道恶性梗阻的特征，各有优势，具有较高的应用价值。 |
| 关键词: CT 磁共振胰胆管造影 腔内超声 胆道恶性梗阻 诊断价值 |
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| Comparison of IDUS, CT and MRCP in diagnosis of malignant biliary obstruction |
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Fang Weiping,Xu Guoqiang,Yu Hongjing
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the First Affiliated Hospital，Zhejiang University School of Medicine
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| Abstract: |
| Objective To compare the application value of intraductal ultrasonography (IDUS), CT scan and magnetic resonance cholangiopancreatography (MRCP) in diagnosis of malignant biliary obstruction. Methods Fifty three patients with malignant biliary obstruction underwent IDUS, CT and MRCP examinations. The image features and detection rate of 3 imaging methods were compared. Results The accurate rates for qualitative diagnosis of IDUS, CT and MRCP were 63.27%, 74.47% and 75.61%, respectively (P＞0.05), the accurate rate of obstructive site diagnosis for the three methods were 65.31%, 82.98% and 82.93%(P＜0.05). All three imaging methods showed the site, quantity and echo/density/signal characteristics of malignant biliary obstruction. CT and MRCP had advantages in positioning diagnosis of ampullary cancer and in qualitative diagnosis of pancreatic cancer. Conclusion IDUS, CT and MRCP can clearly show the characteristics of malignant biliary obstruction with their own advantages. |
| Key words: CT MRCP IDUS Obstructive jaundice Application value |
