Kim Tae Kyoung, Kim Bong Soo, Kim Jung Hoon, Ha Hyun Kwon, Kim Pyo Nyun, Kim Ah Young, Lee Moon-Gyu
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnab-dong, Songpa-ku, Seoul 138-736, Korea.
AJR Am J Roentgenol. 2002 Aug;179(2):429-34. doi: 10.2214/ajr.179.2.1790429.
The purpose of this study was to compare the efficacy of MR cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis of intrahepatic stones.
Of the 318 patients who underwent MRCP examinations at our institution during an 18-month period, we identified 49 patients who subsequently underwent surgery or cholangioscopic stone removal with proof of intrahepatic stones. Thirty-four of these patients also underwent ERCP; they made up our study population. All images were interpreted for the presence of bile duct stones: MRCP images were interpreted independently by two reviewers, and ERCP studies were interpreted by one reviewer who was unaware of the MRCP findings.
The sensitivity and specificity of MRCP for detecting intrahepatic stones were 97% and 93%, respectively, whereas those of ERCP were 59% and 97%, respectively. MRCP showed a significantly higher sensitivity than ERCP in the diagnosis of intrahepatic stones (p < 0.001). We found no significant difference between MRCP and ERCP in sensitivity or specificity for detecting calculi in the common duct or gallbladder.
MRCP is a more effective diagnostic method than ERCP for the evaluation of intrahepatic stones.
本研究旨在比较磁共振胰胆管造影（MRCP）和内镜逆行胰胆管造影（ERCP）对肝内结石的诊断效能。
在我院18个月期间接受MRCP检查的318例患者中，我们确定了49例随后接受手术或经胆道镜取石且有肝内结石证据的患者。其中34例患者还接受了ERCP检查；他们构成了我们的研究人群。所有图像均针对胆管结石的存在进行解读：MRCP图像由两名阅片者独立解读，ERCP检查由一名不知MRCP检查结果的阅片者解读。
MRCP检测肝内结石的敏感性和特异性分别为97%和93%，而ERCP的敏感性和特异性分别为59%和97%。在肝内结石的诊断中，MRCP的敏感性显著高于ERCP（p<0.001）。我们发现MRCP和ERCP在检测胆总管或胆囊结石的敏感性或特异性方面无显著差异。
对于评估肝内结石，MRCP是一种比ERCP更有效的诊断方法。
