Ito K, Fujita N, Noda Y, Kobayashi G, Kimura K, Tada T, Matsunaga A, Yuki T, Nomura M, Sato T, Ishida K, Uchimi K, Senoo S, Okubo K, Suzuki T, Hirasawa D, Sugawara T, Horaguchi J
Sendai City Medical Center, Departmeent of Gastroenterology.
Nihon Shokakibyo Gakkai Zasshi. 2001 Oct;98(10):1164-73.
This study was carried out to clarify the efficacy of magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of biliary tract diseases, Three hundred and eleven patients who underwent MRCP and ERCP during the period from January 1999 to December 1999 at our institution were included in the study. Two gastroenterologists who were blinded to results of direct cholangiography and final diagnoses interpreted MRCP images prospectively. The biliary duct was visualized by MRCP and ERCP in 99.4% and 89.5% of the cases, respectively. The sensitivity, specificity, and accuracy of MRCP in the diagnosis of choledocholithiasis were 95%, 97%, and 97%, respectively. MRCP depicted the presence of strictures with a sensitivity, specificity, and accuracy of 97%, 96%, and 96%, respectively. There were three false-positive cases because of artifacts from arterial compression, The accuracy of MRCP and ERCP in differentiation of benign strictures from malignant ones was 85% and 96%, respectively. Based on these results, it is concluded that MRCP has high capability in visualization of the biliary tree, and in detection of stones and strictures, To avoid over and under-diagnosis, awareness of some pitfalls inherent in, MRCP is important. We suggest that MRCP should be recommended for patients with suspicion of biliary tract diseases in the initial stage of making diagnosis.
本研究旨在阐明磁共振胰胆管造影（MRCP）在胆道疾病诊断中的疗效。1999年1月至1999年12月期间在我院接受MRCP和内镜逆行胰胆管造影（ERCP）的311例患者纳入本研究。两名对直接胆管造影结果和最终诊断不知情的胃肠病学家对MRCP图像进行前瞻性解读。MRCP和ERCP对胆管的显示率分别为99.4%和89.5%。MRCP诊断胆总管结石的敏感性、特异性和准确性分别为95%、97%和97%。MRCP显示狭窄的敏感性、特异性和准确性分别为97%、96%和96%。因动脉压迫伪影出现3例假阳性病例。MRCP和ERCP鉴别良性狭窄与恶性狭窄的准确性分别为85%和96%。基于这些结果，得出结论：MRCP在显示胆管树以及检测结石和狭窄方面具有很高的能力。为避免过度诊断和漏诊，了解MRCP固有的一些陷阱很重要。我们建议，对于疑似胆道疾病的患者，在诊断初期应推荐进行MRCP检查。
