磁共振胰胆管造影（MRCP）与内镜逆行胰胆管造影（ERCP）在评估胆总管和胰管病变中的比较。
Comparison of MRCP and ERCP in the evaluation of common bile duct and pancreatic duct pathologies.
作者信息
Kumar Anand, Mohanty Nihar Ranjan, Mohanty Madhusmita, Dash Sashibhusan
机构信息
Department of Radiodiagnosis, Apollo Hospitals, Bhubaneswar, India.
Department of Radiodiagnosis, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India.
出版信息
Front Med Technol. 2023 Jul 12;5:946555. doi: 10.3389/fmedt.2023.946555. eCollection 2023.
BACKGROUND
Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging modality that has high diagnostic accuracy for a wide range of bile duct and pancreatic duct pathologies. Endoscopic retrograde cholangiopancreatography (ERCP) is still the gold standard for the exploration of the biliopancreatic region.
AIM
The aim of the study was to compare the diagnostic accuracy of MRCP with that of ERCP in the diagnosis of bile duct and pancreatic duct pathologies.
MATERIAL AND METHODS
A total of 60 patients with common bile duct (CBD) and pancreatic duct pathologies detected on MRCP were subsequently evaluated by ERCP in this observational study. A comparison of MRCP findings with ERCP was made.
RESULTS
MRCP had a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 88.1%, 94.4%, 97.3%, 72.7%, and 90%, respectively, in diagnosing choledocholithiasis in comparison to ERCP. For CBD dilation, the sensitivity was 90.91%, specificity was 93.75% and the PPV, NPV, and accuracy were 97.56%, 78.95%, and 91.67%, respectively, for MRCP. In CBD stricture, MRCP showed a sensitivity, specificity, PPV, NPV, and accuracy of 83.33%, 97.92%, 90.91%, 95.92%, and 95%, respectively. In pancreatic duct dilatation, the sensitivity, specificity, PPV, NPV, and accuracy were all 100%. Pancreatic duct stricture showed a sensitivity, specificity, PPV, NPV, and accuracy of 80%, 98%, 88.89%, 96.08%, and 95%, respectively. For the diagnosis of periampullary carcinoma, the sensitivity, specificity, PPV, NPV, and accuracy rate of MRCP were 80%, 98%, 88.89%, 96.08%, and 95%, respectively.
CONCLUSION
No significant difference was found between MRCP and ERCP in diagnosing those six pathologies.
背景
磁共振胰胆管造影（MRCP）是一种非侵入性成像方式，对多种胆管和胰管病变具有较高的诊断准确性。内镜逆行胰胆管造影（ERCP）仍是胆胰区域探查的金标准。
目的
本研究旨在比较MRCP与ERCP在胆管和胰管病变诊断中的诊断准确性。
材料与方法
在这项观察性研究中，对60例经MRCP检测出胆管和胰管病变的患者随后进行了ERCP评估。对MRCP与ERCP的检查结果进行了比较。
结果
与ERCP相比，MRCP诊断胆总管结石的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性分别为88.1%、94.4%、97.3%、72.7%和90%。对于胆总管扩张，MRCP的敏感性为90.91%，特异性为93.75%，PPV、NPV和准确性分别为97.56%、78.95%和91.67%。在胆总管狭窄方面，MRCP的敏感性、特异性、PPV、NPV和准确性分别为83.33%、97.92%、90.91%、95.92%和95%。在胰管扩张方面，敏感性、特异性、PPV、NPV和准确性均为100%。胰管狭窄的敏感性、特异性、PPV、NPV和准确性分别为80%、98%、88.89%、96.08%和95%。对于壶腹周围癌的诊断，MRCP的敏感性、特异性、PPV、NPV和准确率分别为80%、98%、88.89%、96.08%和95%。
结论
在诊断这六种病变方面，MRCP与ERCP之间未发现显著差异。
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