Yun Eun Joo, Choi Chul Soon, Yoon Dae Young, Seo Young Lan, Chang Suk Ki, Kim Joo Seop, Woo Ji Young
Department of Radiology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
J Comput Assist Tomogr. 2009 Jul-Aug;33(4):636-40. doi: 10.1097/RCT.0b013e31817710d5.
To determine the diagnostic accuracy of combined magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT) for preoperative diagnosis of Mirizzi syndrome.
Fifty-two patients with surgically proven Mirizzi syndrome (n = 13) and cholecystitis without evidence for Mirizzi syndrome (n = 39) underwent both MRCP using single-shot turbo spin echo and 3-dimensional turbo spin echo sequences and CT. Two blinded observers independently and retrospectively reviewed the combination of MRCP and CT images and CT images alone. Diagnostic accuracy for a combined protocol and CT was evaluated.
The overall sensitivity, specificity, positive and negative predictive values, and accuracy of the combination of MRCP and CT were 96.0%, 93.5%, 83.5%, 98.5%, and 94.0%, respectively. Corresponding values of CT were 42.0%, 98.5%, 93.0%, 83.5%, and 85.0%, respectively. The sensitivity, negative predictive value, and accuracy of combined protocol were significantly higher than those of CT alone (P = 0.000, 0.001, and 0.042, respectively). Interobserver agreement was better for combined images (kappa = 0.906) than for CT images alone (kappa = 0.812).
A combination of MRCP and CT is useful for preoperative diagnosis of Mirizzi syndrome.
确定磁共振胰胆管造影（MRCP）与计算机断层扫描（CT）联合应用于Mirizzi综合征术前诊断的诊断准确性。
52例经手术证实的Mirizzi综合征患者（n = 13）和无Mirizzi综合征证据的胆囊炎患者（n = 39）接受了使用单次激发快速自旋回波和三维快速自旋回波序列的MRCP检查以及CT检查。两名不知情的观察者独立地对MRCP与CT图像的组合以及单独的CT图像进行回顾性分析。评估联合方案和CT的诊断准确性。
MRCP与CT联合应用的总体敏感性、特异性、阳性和阴性预测值以及准确性分别为96.0%、93.5%、83.5%、98.5%和94.0%。CT的相应值分别为42.0%、98.5%、93.0%、83.5%和85.0%。联合方案的敏感性、阴性预测值和准确性显著高于单独的CT（P分别为0.000、0.001和0.042）。联合图像的观察者间一致性（kappa = 0.906）优于单独的CT图像（kappa = 0.812）。
MRCP与CT联合应用对Mirizzi综合征的术前诊断有用。
