原发性硬化性胆管炎：磁共振胰胆管造影评估——一项病例对照研究

Primary sclerosing cholangitis: evaluation with MR cholangiography-a case-control study.

作者信息

Fulcher A S, Turner M A, Franklin K J, Shiffman M L, Sterling R K, Luketic V A, Sanyal A J

机构信息

Department of Radiology, Medical College of Virginia of Virginia Commonwealth University, Main Hospital, Richmond, VA 23298, USA.

出版信息

Radiology. 2000 Apr;215(1):71-80. doi: 10.1148/radiology.215.1.r00ap2671.

DOI:10.1148/radiology.215.1.r00ap2671

PMID:10751470

Abstract

PURPOSE

To determine the accuracy of magnetic resonance (MR) cholangiography for detection of primary sclerosing cholangitis (PSC) and localization of PSC in the biliary tract.

MATERIALS AND METHODS

In a prospective case-control study involving 102 patients, the MR cholangiograms obtained in 34 patients with PSC established with endoscopic retrograde cholangiopancreatography (ERCP) were compared with the MR cholangiograms obtained in 68 age-matched control patients with hepatobiliary diseases other than PSC. Two abdominal radiologists conducted an independent, blinded random review of the MR cholangiograms to assess for the presence or absence of PSC and determine the location of PSC in the biliary tract, and then compared the findings with those at ERCP.

RESULTS

MR cholangiography was found to be accurate in detecting PSC and in defining the extent of disease. In the detection of PSC, the sensitivities were 88% and 85%; specificities, 97% and 92%; positive predictive values, 94% and 85%; and negative predictive values, 94% and 93% for readers 1 and 2, respectively. Interobserver agreement was excellent (kappa = 0.79). In the localization of extrahepatic PSC, the sensitivities were 83% and 89%; and specificities, 83% and 83% for readers 1 and 2, respectively. Interobserver agreement was good (kappa = 0.62). In the localization of intrahepatic PSC, the sensitivity was 87% for both readers; interobserver agreement was good (kappa = 0.71).

CONCLUSION

MR cholangiography enables accurate detection and localization of PSC.

摘要

目的

确定磁共振（MR）胆管造影术检测原发性硬化性胆管炎（PSC）及在胆道中定位PSC的准确性。

材料与方法

在一项涉及102例患者的前瞻性病例对照研究中，将34例经内镜逆行胰胆管造影术（ERCP）确诊为PSC的患者所获得的MR胆管造影图像，与68例年龄匹配、患有除PSC以外的肝胆疾病的对照患者所获得的MR胆管造影图像进行比较。两名腹部放射科医生对MR胆管造影图像进行独立、盲法随机评估，以判断PSC的有无，并确定PSC在胆道中的位置，然后将结果与ERCP检查结果进行比较。

结果

发现MR胆管造影术在检测PSC及确定疾病范围方面准确。在检测PSC时，读者1和读者2的敏感度分别为88%和85%；特异度分别为97%和92%；阳性预测值分别为94%和85%；阴性预测值分别为94%和93%。观察者间一致性良好（kappa = 0.79）。在肝外PSC定位方面，读者1和读者2的敏感度分别为83%和89%；特异度分别为83%和83%。观察者间一致性良好（kappa = 0.62）。在肝内PSC定位方面，两位读者的敏感度均为87%；观察者间一致性良好（kappa = 0.71）。