中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
1期
33-35
,共3页
丁世华%郭海建%曾理%刘俊
丁世華%郭海建%曾理%劉俊
정세화%곽해건%증리%류준
胆总管结石%诊断%超声检查%胰胆管造影术,内窥镜逆行%胰胆管造影术,磁共振
膽總管結石%診斷%超聲檢查%胰膽管造影術,內窺鏡逆行%胰膽管造影術,磁共振
담총관결석%진단%초성검사%이담관조영술,내규경역행%이담관조영술,자공진
Choledocholithiasis%Diagnosis%Ultrasonography%Cholangiopancreatography,endoscopic retrograde%Cholangiopancreatography,magnetic resonance
目的 对比分析超声内镜(EUS)、核磁共振胰胆管造影(MRCP)及内镜下逆行胰胆管造影(ERCP)诊断中度可疑胆总管结石的价值.方法 186例临床中度可疑胆总管结石患者均先后接受MRCP、EUS、ERCP检查,以内镜取出结石为金标准,比较不同检查方法的敏感度、特异度和准确度.结果 EUS诊断胆总管结石的敏感度为97.5％(155/159),准确度为97.3％(181/186),均显著高于MRCP的92.5％(147/159)和91.9％(171/186),差异有统计学意义(x2=4.21、5.30,P=0.04、0.02);EUS诊断胆总管结石的特异度为96.3％(26/27),与MRCP[88.9％ (24/27)]比较差异无统计学意义(x2=115.40,P＞0.05).ERCP诊断胆总管结石的准确度、敏感度、特异度分别为98.9％(184/186)、98.7％ (157/159)、100.0％(27/27),与EUS比较差异无统计学意义(P＞0.05).结论 EUS诊断胆总管结石的价值与ERCP相似,中度可疑胆总管结石ERCP术前行EUS或MRCP检查可以避免不必要的ERCP.
目的 對比分析超聲內鏡(EUS)、覈磁共振胰膽管造影(MRCP)及內鏡下逆行胰膽管造影(ERCP)診斷中度可疑膽總管結石的價值.方法 186例臨床中度可疑膽總管結石患者均先後接受MRCP、EUS、ERCP檢查,以內鏡取齣結石為金標準,比較不同檢查方法的敏感度、特異度和準確度.結果 EUS診斷膽總管結石的敏感度為97.5％(155/159),準確度為97.3％(181/186),均顯著高于MRCP的92.5％(147/159)和91.9％(171/186),差異有統計學意義(x2=4.21、5.30,P=0.04、0.02);EUS診斷膽總管結石的特異度為96.3％(26/27),與MRCP[88.9％ (24/27)]比較差異無統計學意義(x2=115.40,P＞0.05).ERCP診斷膽總管結石的準確度、敏感度、特異度分彆為98.9％(184/186)、98.7％ (157/159)、100.0％(27/27),與EUS比較差異無統計學意義(P＞0.05).結論 EUS診斷膽總管結石的價值與ERCP相似,中度可疑膽總管結石ERCP術前行EUS或MRCP檢查可以避免不必要的ERCP.
목적 대비분석초성내경(EUS)、핵자공진이담관조영(MRCP)급내경하역행이담관조영(ERCP)진단중도가의담총관결석적개치.방법 186례림상중도가의담총관결석환자균선후접수MRCP、EUS、ERCP검사,이내경취출결석위금표준,비교불동검사방법적민감도、특이도화준학도.결과 EUS진단담총관결석적민감도위97.5％(155/159),준학도위97.3％(181/186),균현저고우MRCP적92.5％(147/159)화91.9％(171/186),차이유통계학의의(x2=4.21、5.30,P=0.04、0.02);EUS진단담총관결석적특이도위96.3％(26/27),여MRCP[88.9％ (24/27)]비교차이무통계학의의(x2=115.40,P＞0.05).ERCP진단담총관결석적준학도、민감도、특이도분별위98.9％(184/186)、98.7％ (157/159)、100.0％(27/27),여EUS비교차이무통계학의의(P＞0.05).결론 EUS진단담총관결석적개치여ERCP상사,중도가의담총관결석ERCP술전행EUS혹MRCP검사가이피면불필요적ERCP.
Objective To compare the effect of endoscopic ultrasonography (EUS),magnetic resonance chlangiopancreatography (MRCP) and endoscopic retrograde cholangiography (ERCP) in the diagnosis of suspicious intermediate choledocholithiasis.Methods One hundred and eighty-six patients with suspicious intermediate of choledocholithiasis successively received MRCP,EUS,and ERCP examination.The stone taking out by endoscopic as diagnositic standard,and the sensitivity,specificity and accuracy in different methods was compared.Results Sensitivity and accuracy of EUS was significantly higher than that of MRCP [97.5％(155/159) vs.92.5％(147/159),97.3％(181/186) vs.91.9％(171/186)](x2 =4.21,5.30,P =0.04,0.02).There was no statistically significant difference between EUS and ERCP in specificity [96.3％(26/27) vs.88.9％ (24/27)] (x2 =115.40,P ＜ 0.05).Sensitivity,specificity and accuracy of ERCP was 98.9％(184/186),98.7％(157/159) and 100.0％(27/27),and there was no difference between EUS and ERCP in the diagnosis of choledocholithiasis (P ＞ 0.05).Conclusions EUS is similar with ERCP for the diagnosis of choledocholithiasis.By performing EUS or MRCP first,ERCP may be avoided in patients with suspicious intermediate choledocholithiasis.
