CAJ | 학술논문

目的探讨胆管腔内超声(IDUS)对于判断胆管狭窄性质的临床应用价值.方法收集2006年至2010年因胆管狭窄行胆管腔内超声检查后手术患者,将IDUS结果与手术结果进行对照.结果 49例患者中良性狭窄6例,恶性狭窄43例；IDUS判断胆管狭窄性质的敏感度为97.7％( 42/43),特异度为83.3％ (5/6),阳性预测值为97.7％(42/43),阴性预测值为83.3％(5/6),准确性为95.9％(47/49);显著高于传统的影像学检查(B超、CT及MRCP).32例患者曾行胆道刷片检查,其中21例诊断为恶性狭窄,准确率为65.6％.所有胆道刷片诊断为恶性狭窄病例均已经被IDUS所诊断.结论胆管腔内超声可以有效判断胆管狭窄的性质,指导临床治疗.ERCP术中IDUS基础上行胆道刷片对于胆管恶性狭窄诊断价值有限,但是对于明确病理诊断有一定的帮助.
목적 탐토담관강내초성(IDUS)대우판단담관협착성질적림상응용개치.방법 수집2006년지2010년인담관협착행담관강내초성검사후수술환자,장IDUS결과여수술결과진행대조.결과 49례환자중량성협착6례,악성협착43례；IDUS판단담관협착성질적민감도위97.7％( 42/43),특이도위83.3％ (5/6),양성예측치위97.7％(42/43),음성예측치위83.3％(5/6),준학성위95.9％(47/49);현저고우전통적영상학검사(B초、CT급MRCP).32례환자증행담도쇄편검사,기중21례진단위악성협착,준학솔위65.6％.소유담도쇄편진단위악성협착병례균이경피IDUS소진단.결론 담관강내초성가이유효판단담관협착적성질,지도림상치료.ERCP술중IDUS기출상행담도쇄편대우담관악성협착진단개치유한,단시대우명학병리진단유일정적방조.
Objective To investigate the diagnostic value of intraductal ultrasonography for the quality of biliary stricture.Methods Data of the patients who had received operation because of biliary stricture after IDUS examination from 2006 to 2010 were collected.IDUS results were compared with those of operation.Results There were 43 cases of malignant strictures and 6 benign strictures in total.The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of intraductal uhrasonography for the quality of biliary stricture were 97.7％ ( 42/43 ),83.3％ ( 5/6 ),97.7％ ( 42/43 ),83.3％ (5/6) and 95.9％ (47/49),respectively,which were significantly higher than conventional imaging like ultrasound B,CT and MRCP.Twenty one cases in 32 were diagnosed as malignant biliary stricture with cytological brushing,with the diagnostic accuracy of 65.6％.All cases had been diagnosed by IDUS.Conclusion Intraductal ultrasonography is of high diagnostic value for biliary stricture.However,cytological brushing based on IDUS is of limited diagnostic value for malignant biliary stricture.