磁共振胰胆管造影、超声内镜与逆行胰胆管造影诊断阻塞性黄疸的价值

目的：比较磁共振胰胆管造影（MRCP）、超声内镜（EUS）与内镜逆行胰胆管造影（ERCP）诊断阻塞性黄疸的价值。方法：39例阻塞性黄疸患者分别行MRCP、EUS和ERCP。MRCP采用重T2加权及超快速自旋回波水成像技术进行，EUS和ERCP按常规进行。结果：MRCP、EUS与ERCP诊断准确率分别为87．2％（34／39例）、94．9％（37／39例）和97．4％（38／39例）；对恶性狭窄的诊断准确率分别为61．5％（8／13例）、84．6％（11／13例）和92．3％（12／13例）；对胆总管结石的诊断准确率均为100．0％（21／21例）。结论：MRCP为无创性检查，在明确阻塞性黄疸病因时可作为首选方法，目前尚不能取代ERCP。EUS作为诊断胆、胰系统疾病的重要方法，与MRCP和ERCP结合，能提高阻塞性黄疸诊断 的准确率。

Diagnostic value of MRCP, EUS and ERCP in the diagnosis of obstructive jaundice

Objective To compare the diagnostic value of magnetic resonance cholangio pancreatography (MRCP), endoscopic ultrasonography (EUS) and endoscopic retrograde cholangio pancreatography (ERCP) in obstructive jaundice. Methods MRCP, EUS and ERCP were performed in 39 patients with obstructive jaundice. MRCP was performed by the technique of T2 weighted fast spin echo fluid imaging. EUS and ERCP were performed with conventional method. Results The over all concordance rates of MRCP, EUS and ERCP were 87.2%(34/19), 94.9%(37/39) and 97.4(38/39), respectively. In malignant common duct stricture the concordance rates of MRCP, EUS and ERCP were 61.5%(8/13), 84.6%(11/13) and 92.3%(12/13), respectively. In choledocholithiasis the concordance rates of MRCP, EUS and ERCP were 100.0%(21/21). Conclusion The non invasive examination, MRCP can be the first choice as a diagnostic method for obstructive jaundice, but it can not replace ERCP currently. As an important approach to diagnose the cholangiopancreatic disease, EUS combine with MRCP and ERCP, can improve the diagnostic accuracy in obstructive jaundice.