Alsaigh Sultan, Aldhubayb Majed A, Alobaid Abdulaziz S, Alhajjaj Athkar H, Alharbi Bader A, Alsudais Deem M, Alhothail Hatoon A, AlSaykhan Mohammed A
General Surgery, King Fahad Specialist Hospital, Buraidah, SAU.
Radiology, King Fahad Specialist Hospital, Buraidah, SAU.
Cureus. 2020 Oct 16;12(10):e10987. doi: 10.7759/cureus.10987.
Background Challenges in the diagnosis of obstructive jaundice include locating the level of obstruction, knowing the cause of obstruction, and differentiating between benign and malignant causes. Imaging plays a significant role in detecting the causes of obstruction. Radiologists aim to diagnose biliary obstruction, its level, extent, and probable causes to determine the appropriate treatment for each case. Methods Our study is a retrospective medical record review study. It included 150 patients who had ultrasound (US) diagnosis of biliary obstruction and underwent magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP) in King Fahad Specialist Hospital, Buraidah. The patients' medical records have been reviewed to measure the sensitivity and specificity of US, MRCP, and ERCP. Results Statistical analysis of the data showed that the sensitivity of US in detecting the most common cause of biliary obstruction, common bile duct (CBD) stone, was 26.6%, while the specificity was 100%. Comparing this sensitivity of US in detecting CBD stones to that of MRCP and ERCP, we obtained the following: US, 26.6%; MRCP, 62.9%; and ERCP, 62.4%. Although US was the least sensitive for detecting CBD stones, its specificity in this detection was 100%, while MRCP was 63.6%, and ERCP was 55.2%. Conclusion US is the best initial step for the diagnosis of biliary obstruction. However, MRCP and ERCP are more sensitive in detecting CBD stones compared to US. Also, compared to US, they have shown higher percentages in all aspects of detection: level, cause, and extent of biliary obstruction.
背景 阻塞性黄疸的诊断面临诸多挑战，包括确定梗阻部位、了解梗阻原因以及区分良性和恶性病因。影像学检查在查明梗阻原因方面发挥着重要作用。放射科医生旨在诊断胆道梗阻、其部位、范围及可能的病因，以便为每个病例确定合适的治疗方案。 方法 我们的研究是一项回顾性病历审查研究。研究纳入了150例在布赖代法赫德国王专科医院经超声（US）诊断为胆道梗阻并接受磁共振胰胆管造影（MRCP）或内镜逆行胰胆管造影（ERCP）的患者。对患者的病历进行了审查，以评估US、MRCP和ERCP的敏感性和特异性。 结果 数据的统计分析表明，US检测胆道梗阻最常见原因即胆总管（CBD）结石的敏感性为26.6%，而特异性为100%。将US检测CBD结石的敏感性与MRCP和ERCP的敏感性进行比较，结果如下：US为26.6%；MRCP为62.9%；ERCP为62.4%。尽管US检测CBD结石的敏感性最低，但其在该检测中的特异性为100%，而MRCP为63.6%，ERCP为55.2%。 结论 US是诊断胆道梗阻的最佳初始步骤。然而，与US相比，MRCP和ERCP在检测CBD结石方面更敏感。此外，与US相比，它们在胆道梗阻的部位、原因和范围等所有检测方面均显示出更高的百分比。
