B超、CT、MRI/MRCP联合CA19-9检测对恶性梗阻性黄疸的诊断价值

目的探讨B超、CT、MRI/MRCP联合CA19-9检测对恶性梗阻性黄疸的诊断价值.方法对资料齐全,诊断明确的44例恶性梗阻性黄疸病人的临床资料进行分析.结果单项检查,B超定位准确率97.7%(43/44),定性准确率72.7%(32/44);CT定位准确率97.7%(43/44),定性准确率79.5%(35/44);MRI/MRCP定位准确率100%(44/44),定性准确率88.6%(39/44).统计学分析:3项检查的定位诊断率和定性诊断率均无显著性差异(P＞0.05).B超、CT联合CA19-9检测定性准确率均为97.7%(43/44),MRI/MRCP联合CA19-9检测定性准确率100%.结论影像学检查和血清CA19-9检测诊断恶性梗阻性黄疸各有优势与不足.二者联合可以大大提高诊断正确率,可作为可疑恶性梗阻性黄疸的常规检查方法.

The value of B-US, CT and MRI/MRCP combine with CA19-9 in diagnosis of malignant obstructive jaundice

Objective To evaluate the value of B-US,CT and MRI/MRCP combine with CA19-9 in diagnosis of malignant obstructive jaundice.Methods The clinical data of 44 patients with malignant obstructive jaundice were analyzed.Results The correct diagnostic rates of each imaging modality in finding positions and causes of obstruction,B-US were 97.7% and 72.7%,CT were 97.7% and 79.5%,MRI/MRCP were 100% and 88.6%.The differences among them were not significant(P>0.05).Combined with CA19-9,the correct rates of finding obstructive causes were 97.7% by B-US and CT,100% by MRI/MRCP.Conclusion Both imaging modalities and CA19-9 have their advantages and disadvantages in diagnosing malignant obstructive jaundice.The combination can raise the accuracy of diagnose significantly,should become routine examination of suspicious malignant obstructive jaundice.