多排螺旋 CT 多平面重建对十二指肠乳头旁憩室的评估：与 ERCP 结果的相关性。

Evaluation of juxtapapillary duodenal diverticula using multiplanar reformation in MDCT: correlation with ERCP findings.

机构信息

Department of Radiology, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.

Department of Gastroenterology, Oita University Faculty of Medicine, Oita, Japan.

出版信息

Jpn J Radiol. 2020 Oct;38(10):968-972. doi: 10.1007/s11604-020-00995-5. Epub 2020 Jun 2.

DOI:10.1007/s11604-020-00995-5

PMID:32488500

Abstract

OBJECTIVE

To determine the ability of multidetector computed tomography (MPR-MDCT) to identify and classify the juxtapapillary duodenal diverticulum (JPDD), with ERCP findings as the gold standard.

METHODS

We retrospectively reviewed all ERCP examinations (n: 455) performed between January 2010 to December 2018 and selected 105 patients with JPDD as the inclusion criteria. Of those, 28 patients were excluded because of advanced pancreatic carcinoma, incomplete MDCT examinations and biliary catheter insertion. Finally, MDCT examinations of 77 patients with JPDD were assessed for the presence and type of JPDD.

RESULTS

MPR-MDCT was able to identify 71 (92.2%) JPDD in 77 cases with 88.9% accuracy, 83.3% sensitivity, and 91.6% specificity in classifying the type of JPDD. MPR-MDCT performed best in determining type 1 JPDD, with accuracy of 95.4% compared with type 2 (83.3%) and type 3 (87.8%). There was no significant difference between age, gender, incidence of biliary stones and pancreatitis between each type of JPDD. No correlation of sizes with types of JPDD was found.

CONCLUSIONS

MPR-MDCT can accurately identify and classify JPDD. This information will be useful in determining the difficulty of ERCP.

摘要

目的

以 ERCP 结果为金标准，确定多层螺旋 CT（MPR-MDCT）识别和分类胰头旁十二指肠憩室（JPDD）的能力。

方法

我们回顾性分析了 2010 年 1 月至 2018 年 12 月期间进行的所有 ERCP 检查（n=455），并选择了 105 例 JPDD 患者作为纳入标准。其中，28 例因晚期胰腺癌、MDCT 检查不完整和胆管插入而被排除。最终，评估了 77 例 JPDD 患者的 MDCT 检查结果，以确定 JPDD 的存在和类型。

结果

MPR-MDCT 能够识别 77 例中有 71 例（92.2%）JPDD，其准确性为 88.9%，敏感度为 83.3%，特异性为 91.6%。MPR-MDCT 在确定 1 型 JPDD 方面表现最佳，准确性为 95.4%，而 2 型（83.3%）和 3 型（87.8%）的准确性较低。在每种 JPDD 类型中，年龄、性别、胆道结石和胰腺炎的发生率均无显著差异。未发现 JPDD 类型与大小之间存在相关性。