磁共振胰胆管造影（MRCP）和内镜超声在恶性胆总管狭窄诊断中的相对作用：一项严格评价的主题。
The relative roles of magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound in diagnosis of malignant common bile duct strictures: a critically appraised topic.
作者信息
McMahon Colm J
机构信息
Department of Diagnostic Imaging, St. James Hospital, Dublin 8, Ireland,
出版信息
Abdom Imaging. 2008 Jan-Feb;33(1):10-3. doi: 10.1007/s00261-007-9305-2.
BACKGROUND
The relative roles of magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS) in the investigation of malignant common bile duct (CD) strictures were evaluated using "evidence-based practice" (EBP) methodology.
METHODS
A focused clinical question was constructed. A structured search of primary and secondary evidence was performed. Retrieved studies were appraised for validity, strength and level of evidence (Oxford/CEBM scale: 1-5).
RESULTS
Three studies were eligible for inclusion; there were 2 level 3b and 1 level 4 papers. One paper included a patient group appropriate to the question and contained sufficient data to allow analysis. Sensitivity and specificity of MRCP and EUS were (90%, 65%) and (80%, 80%), respectively.
CONCLUSION
In the diagnosis of malignant CD strictures, EUS is more specific than MRCP and may allow cytology to be obtained via a trans-duodenal approach. A multi modality imaging approach is recommended.
背景
采用“循证医学实践”（EBP）方法评估磁共振胰胆管造影（MRCP）和内镜超声（EUS）在恶性胆总管（CD）狭窄检查中的相对作用。
方法
构建一个重点临床问题。对一级和二级证据进行结构化检索。对检索到的研究进行有效性、强度和证据水平评估（牛津/循证医学中心量表：1 - 5级）。
结果
三项研究符合纳入标准；其中2篇为3b级论文，1篇为4级论文。一篇论文纳入了与问题相关的患者组，并包含足够的数据进行分析。MRCP和EUS的敏感性和特异性分别为（90%，65%）和（80%，80%）。
结论
在恶性CD狭窄的诊断中，EUS比MRCP更具特异性，并且可以通过经十二指肠途径获取细胞学检查样本。建议采用多模态成像方法。
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