磁共振胰胆管造影对胆道疾病患者的前瞻性评估：与传统超声及内镜逆行胰胆管造影诊断算法的对比研究

Prospective evaluation of magnetic resonance cholangiopancreatography in patients with biliary disease: comparative study with conventional ultrasonography and endoscopic retrograde cholangiopancreatography diagnostic algorithm.

作者信息

Pamos S, Benages A, Medina E, Martinez Sanjuan V

机构信息

Department of Digestive Pathology, Hospital General Universitario, Valencia, Spain.

出版信息

Dig Liver Dis. 2003 Mar;35(3):186-92. doi: 10.1016/s1590-8658(03)00027-6.

DOI:10.1016/s1590-8658(03)00027-6

PMID:12779073

Abstract

BACKGROUND

Magnetic resonance cholangiopancreatography is an accurate technique that can replace invasive diagnostic methods of the biliary and pancreatic duct.

AIMS

Our aim was to assess sensitivity and specificity of magnetic resonance cholangiopancreatography and ultrasonography using the results of endoscopic retrograde cholangiopancreatography as reference, and to establish a diagnostic algorithm under which circumstances magnetic resonance cholangiopancreatography can replace endoscopic retrograde cholangiopancreatography.

PATIENTS

Eighty-three patients with suspicion of biliary disease based on clinical, biochemical and ultrasonography findings were studied.

METHODS

Ultrasonography, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography were performed, comparing the results of the techniques for the determination of their sensitivity and specificity.

RESULTS

Sensitivity and specificity results obtained by magnetic resonance cholangiopancreatography were: 100 and 92.8% when dilated ducts were detected (n=61); 97.4 and 97.2% in the diagnosis of choledocholithiasis (n=38); 100 and 96.7% in malignant lesions (n=14) and 81.8 and 98.4% when biliary ducts were normal. The percentage of images of diagnostic quality was 97.6%. Sensitivity and specificity achieved by ultrasonography was: 100 and 57.1% in detection of dilatation, 71 and 97.2% in choledocholithiasis, 92.8 and 96.7% in malignancy and 66.6 and 96.8% in normal ducts.

CONCLUSIONS

Magnetic resonance cholangiopancreatography is a technique with high sensitivity and specificity in the evaluation of biliary ducts. Thus, magnetic resonance cholangiopancreatography may replace diagnostic endoscopic retrograde cholangiopancreatography for purely diagnostic purposes, following an initial clinical and ultrasonographic exam.

摘要

背景

磁共振胰胆管造影是一种准确的技术，可替代胆管和胰管的侵入性诊断方法。

目的

我们的目的是以内镜逆行胰胆管造影的结果为参照，评估磁共振胰胆管造影和超声检查的敏感性和特异性，并建立一种诊断算法，以确定在何种情况下磁共振胰胆管造影可替代内镜逆行胰胆管造影。

患者

基于临床、生化和超声检查结果，对83例疑似胆道疾病的患者进行了研究。

方法

进行了超声检查、磁共振胰胆管造影和内镜逆行胰胆管造影，并比较了这些技术的结果以确定其敏感性和特异性。

结果

磁共振胰胆管造影获得的敏感性和特异性结果为：检测到扩张胆管时（n = 61）分别为100%和92.8%；诊断胆总管结石时（n = 38）分别为97.4%和97.2%；诊断恶性病变时（n = 14）分别为100%和96.7%；胆管正常时分别为81.8%和98.4%。诊断质量图像的百分比为97.6%。超声检查获得的敏感性和特异性为：检测扩张时分别为100%和57.1%；诊断胆总管结石时分别为71%和97.2%；诊断恶性病变时分别为92.8%和96.7%；胆管正常时分别为66.6%和96.8%。