超声内镜对核磁共振胰胆管造影术阴性胆总管结石的诊断价值

目的]探讨超声内镜(endoscopic ultrasonography,EUS)对核磁共振胰胆管造影术(magnetic resonance cholangiopancreatography,MRCP)显示阴性的胆总管结石的诊断价值.方法]回顾性分析完善EUS、MRCP两项检查诊断为胆总管结石81例患者的临床资料.通过SPSS统计学方法、χ^2检验对比分析两项检查方法对胆总管结石的诊断差别,研究EUS对MRCP显示阴性的胆总管结石的影像特征及临床价值.以内镜逆行胰胆管造影术取出结石或采用Seldinger's技术经穿刺道取出结石、经T管胆道镜取出结石为金标准.结果]81例均经临床治疗取出结石.EUS、MRCP对该81例胆总管结石的检出率分别为90.1%(73/81)、79.0%(64/81),差异有统计学意义(χ^2=9.225,P<0.01).经对EUS诊断为阳性、而MRCP诊断为阴性的12例患者基本信息分析表明,EUS对扩张胆总管的诊断高于MRCP,但二者对扩张胆总管最大直径的测量比较差异无统计学意义(P>0.05).结论]EUS对胆总管结石的诊断优于MRCP,尤其对MRCP显示阴性的胆总管结石有独特的优势;二者对于扩张胆总管直径的测量,无显著差异.

The diagnostic value of endoscopic ultrasonography in MRCP negative choledocholithiasis

Objective]The aim of this study to evaluate the value of endoscopic ultrasonography(EUS)in the diagnosis of common bile duct stones with negative findings of magnetic resonance cholangiopancreatography(MRCP).Method]The patients with common bile duct stones,which were diagnosed by Endoscopic retrograde cholangiopancreatography(ERCP),Seldinger's technology or the T tube choledochoscope were collected from January 1,2015 to December 31,2018 in Xiangyang center hospital.Retrospective study was carried out among them.These patients accepted both examinations of EUS and MRCP at the same time.The difference between the two examinations in the diagnosis of choledocholithiasis was compared by SPSS statistics and chi-square analysis.At the same time,the study evaluated the image characteristics and clinical value of EUS for common bile duct stones with negative MRCP.Results]From January 1,2015 to December 31,2018,481 cases of common bile duct stones were diagnosed by EUS in Xiangyang central hospital.A total of 753 cases were diagnosed by MRCP,of which 81 cases were simultaneously performed by two examinations.The detection rates of EUS and MRCP were 90.1%(73/81)and 79.0%(64/81)respectively,with statistically significant differences(χ^2=9.225,P<0.01).When comparing the diameter of the dilated common bile duct between the two groups,the difference was not statistically significant.Conclusion]EUS is superior to MRCP in the diagnosis of common bile duct stones,especially for common bile duct stones with negative MRCP. There is no significant difference in the measurement of dilated common bileduct diameter between the two groups.