CT联合MR多序列成像对胆总管小微结石的诊断价值

目的探讨CT联合磁共振(magnetic resonance, MR)多序列成像对胆总管小微结石的诊断价值。方法回顾性收集上海市静安区市北医院放射科2019年3月—2021年7月所有行上腹部CT平扫和磁共振胰胆管水成像（magnetic resonance cholangiopancreatography, MRCP）检查并经内镜逆行胰胆管造影（endoscopic retrograde cholangiopancreatography, ERCP）证实的胆总管小微结石病例的影像及临床资料,共计55例。对比分析CT、磁共振各序列及两者联合诊断胆总管小微结石的阳性率。结果对于55例胆总管小微结石,CT薄层扫描检出阳性率为56.4%,MR多序列扫描阳性率为80.6%,MR多序列扫描对胆总管小微结石诊断优于CT扫描（χ2=7.08,P<0.05）。CT联合MR多序列阳性率为98.2%,CT联合MR多序列扫描诊断胆总管小微结石优于两种单独检查方法（χ2的值分别为27.38,P<0.01；9.35,P<0.05）。对于22例胆总管微结石,CT薄层扫描阳性率为40.9%,MR多序列扫描阳性率为68.2%,两者比较差异无统计学意义（χ2=3.30,P>0.05）,CT联合MR多序列扫描阳性率为95.5%,CT联合MR多序列扫描诊断胆总管微结石也优于两种单独检查方法（χ2的值分别为15.09,P<0.01；5.50,P<0.05）。结论CT联合MR多序列成像有利于提高胆总管小微结石诊断的检出率,对胆总管小微结石的诊疗具有重要价值。

Diagnostic value of CT combined with MR multi-sequence imaging for small and microlithiasis of the common bile duct

ObjectiveTo explore the diagnostic value of CT combined with magnetic resonance multi-sequence imaging in the diagnosis of common bile duct small and microlithiasis. MethodsThe results of upper abdominal CT plain scans and magnetic resonance cholangiopancreatography(MRCP) examinations in Department of Radiology, Shibei Hospital of Shanghai Jingan District from March 2019 to July 2021 were retrospectively reviewed. The images and clinical data of 55 cases of small and microlithiasis in the common bile duct confirmed by endoscopic retrograde cholangiopancreatography(ERCP) were collected. The positive rates of small and microlithiasis in the common bile duct diagnosed by CT, MRI sequences and their combination were compared. ResultsFor 55 cases of small and microlithiasis of the common bile duct, the positive rate of MR multi-sequence scanning was higher than that of CT thin-slice scanning(80.6% vs 56.4%, χ2=7.08, P<0.05); while the positive rate of the combination of two imaging method(98.2%) was higher than that of each single method(χ2=27.38, P<0.01; χ2=9.35, P<0.05). For 22 cases of common bile duct microlithiasis, there was no significant difference in positive rate between MR multi-sequence scanning and CT thin-slice scanning(68.2% vs 40.9%, χ2=3.30, P>0.05); while the positive rate of the combination of two imaging method(95.5%) was higher than that of each single method(χ2=15.09, P<0.01; χ2=5.50, P<0.05). ConclusionCT combined with MR multi-sequence imaging is beneficial to improve the detection rate of small and microlithiasis of the common bile duct.