不同影像学检查方法对梗阻性黄疸诊断价值的比较研究

目的探讨梗阻性黄疸病人的病因及评价超声、腹部CT（CT）、核磁胰胆管成像（MRCP）、经内镜逆行胰胆管造影（ERCP）和经皮经肝胆道造影（PTC）五种检查方法对梗阻性黄疸的诊断价值。方法选择2003年1月-2009年l1月在我院住院确诊为梗阻性黄疸的患者,比较分析各种检查方法对梗阻部位及梗阻病因的准确率。结果确诊为梗阻性黄疸的患者为473例,B超、腹部CT、MRCP、ERCP及PTC对患者梗阻部位的显示率分别为59.6%（257/431）,80.9%（106/131）,88.8%（326/367）,84.2%（64/76）,100%（31/31）,而梗阻的原因有：Mirrizi综合征、胆道感染、胆道蛔虫、胆囊癌、胆总管结石、胆总管囊肿、肝内外胆管细胞癌、壶腹癌、十二指肠乳头癌、十二指肠乳头憩室、十二指肠乳头炎、术后胆管狭窄、胃癌术后肝门淋巴结转移、胰头癌、肿块性胰腺炎。结论各种诊断方法各有其优缺点,MRCP在梗阻性黄疸的诊断上具有较大的价值,但必要时仍需进行其它检查方法加以鉴别诊断。

Contrast research of different imaging diagnosis methods on obstructive jaundice

Objective To evaluate the application of ultrasound, CT, MRCP, ERCP and PTC in obstructive jaundice. Methods Patients diagnosed as obstructive jaundice from Jan 2003 to Nov 2009 were included in this study. The indication ratio of every method was calculated and compared. Results 473 patients were included, and the indication ratio of ultrasound, CT, MRCP, ERCP and PTC in obstructive jaundice was 59.6%（257/431）,80.9%（106/131）,88.8%（326/367）,84.2%（64/76）,100%（31/31）, and there are fifteen diseases in these patients. Conclution Every method has its own advantages and disadvantages. MRCP is better than others. However, MRCP has limited specificity for diagnosis, so that more tests are still required when necessary.