急性胆源性胰腺炎的病因影像学诊断

目的探讨经腹超声、CT及超声内镜对急性胆源性胰腺炎的病因诊断价值。方法回顾分析2016年9月至2020年9月我院62例疑似急性胆源性胰腺炎伴胆总管结石患者的临床资料,以ERCP为"金标准",评价经腹超声、CT扫描及超声内镜这3种影像方法对急性胆源性胰腺炎的病因诊断价值。结果通过对急性胆源性胰腺炎病因诊断的敏感性、准确性、阴性预测值的比较,3种影像方法之间差异有显著统计学意义(P<0.05)。特异性、阳性预测值相比较,3种影像方法之间差异无显著统计学意义(P>0.05)。3种影像方法ROC曲线下面积比较,超声内镜>CT扫描>经腹超声(P<0.05)。结论对于急性胆源性胰腺炎的病因诊断而言,超声内镜诊断价值最高,CT扫描次之,经腹超声较低。术前进行超声内镜检查有助于鉴别急性胆源性胰腺炎的病因,避免不必要的ERCP治疗。

Imaging Diagnosis of the Etiology of Acute Biliary Pancreatitis

Objective To explore the value of transabdominal ultrasound,CT,and endoscopic ultrasonography in the diagnosis of acute biliary pancreatitis.Methods The clinical data of 62 patients with suspected acute biliary pancreatitis and choledocholithiasis in our hospital from september 2016 to september 2020 were retrospectively analyzed.With ERCP as the"gold standard",the diagnostic value of transabdominal ultrasound,CT,and endoscopic ultrasonography in the etiology of acute biliary pancreatitis was evaluated.Results There were significant differences in sensitivity,accuracy and negative predictive value among the three imaging methods(P<0.05).There was no significant difference in specificity and positive predictive value among the three imaging methods(P>0.05).The area under ROC curve of three imaging methods was endoscopic ultrasound>CT scan>transabdominal ultrasound(P<0.05).Conclusion For the etiology diagnosis of acute biliary pancreatitis,endoscopic ultrasonography is the most valuable,followed by CT scan and low by abdominal ultrasound.Preoperative endoscopic examination is helpful to identify the causes of acute biliary pancreatitis and avoid unnecessary ERCP treatment.