ERCP、MRI、螺旋CT对胰胆管疾病诊断分析

目的比较ERCP、CT、MRI对胰胆管疾病的诊断准确性。方法85例临床表现为黄疸，反复上腹部疼痛，恶心呕吐者均行ERCP、CT及MRI检查。本组经过手术，活检，病理证实为胆总管结石44例。20例为胰腺癌，10例胆管癌，7例为慢性胰腺炎，4例胆道蛔虫。结果胆总管结石诊断准确率ERCP97．7％．CT90％，MR146％；胰腺癌ERCP100％，CT90％，MRI93％；胆管癌ERCP80％，CT90％，MR160％；慢性胰腺炎ERCP85％，CT100％，MRI71％；胆道蛔虫ERCP100％，CT75％，MRI无病例。结论ERCP对胰胆管病变诊断准确率较高，是可靠的诊断手段。CT对恶性肿瘤定性诊断准确率也较高，且无创伤。MRI对梗阻型确诊率较高，且可观察周围组织情况有无创伤。所以，三种检查方法可以进行互补。

ERCP,MRI and CT for diagnosing lesions of cholangiopancreatic duct

Objective To compare the accuracy among ERCP, CT and MRI for diagnosing lesions of cholangiopancreatic duct. Methods 85 patients with clinically presented jaundice, repeated midsection pain, nausea and vomitting underwent ERCP,CT and MRI examinations. In all patients, surgery, biopsy and pathology demonstrated 44 cases of calculus of choledoch,20 cases of carcinoma of pancreatic gland, IO cases of carcinoma of bile duct, 7 cases of chronic pancreatitis and 4 cases of ascariasis of bile duct, Results This study showed the rate of accurate of ERCP,CT and MRI were 97.7%,90%,46% in calculus of choledoch;100%,90%,93% in carcinoma of pancreatic gland;80%,90%, 60% in carcinoma of bile duct;85%,100%,71% in chronic pancreatitis, respectively. The accuracy of ERCP,CT was 100%,75% in ascariasis of bile duct,which underwent ERCP and CT examinations. Conclusion The rate of accurate diagnose of ERCP for lesions of cholangiopancreatic duct is higher, and this kind of technique is reliable. CT is a non-invasive technique with upper accuracy in the qualitative diagnosis of some malignant tumors. MRI also is a non-invasive technique with upper accuracy for diagnosing obstructions and is helpful to observe tissue around. Therefore we should consider the complementarity of ERCP, CT and MRI.