胆总管结石：磁共振胰胆管造影与内镜逆行胰胆管造影的比较

Choledocholithiasis: comparison of MR cholangiography and endoscopic retrograde cholangiography.

作者信息

Chan Y L, Chan A C, Lam W W, Lee D W, Chung S S, Sung J J, Cheung H S, Li A K, Metreweli C

机构信息

Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.

出版信息

Radiology. 1996 Jul;200(1):85-9. doi: 10.1148/radiology.200.1.8657949.

DOI:10.1148/radiology.200.1.8657949

PMID:8657949

Abstract

PURPOSE

To prospectively compare magnetic resonance (MR) cholangiography with endoscopic retrograde cholangiography (ERC) in the diagnosis of choledocholithiasis.

MATERIALS AND METHODS

Forty-seven patients with suspected choledocholithiasis underwent non-breath-hold, heavily T2-weighted, respiratory-triggered turbo spin-echo MR cholangiography. They then underwent ERC within 5 hours. The results of the two procedures were compared in 45 patients.

RESULTS

The absence of ductal dilatation was shown in 16 patients at MR cholangiography and at ERC. MR cholangiography showed common duct dilatation in 28 of the 29 patients with dilatation shown at ERC. MR cholangiography helped correctly identify 18 of the 19 patients with choledocholithiasis and 22 of the 26 patients without choledocholithiasis. Sensitivity with MR cholangiography was 95%, specificity was 85%, positive predictive value was 82%, and negative predictive value was 96%. Two of the false-positive findings were due to pneumobilia.

CONCLUSION

Non-breath-hold MR cholangiography is as accurate for the evaluation of choledocholithiasis as ERC.

摘要

目的

前瞻性比较磁共振（MR）胆管造影与内镜逆行胆管造影（ERC）在胆总管结石诊断中的应用。

材料与方法

47例疑似胆总管结石患者接受了非屏气、重T2加权、呼吸触发的涡轮自旋回波MR胆管造影检查。然后在5小时内接受ERC检查。对45例患者的两种检查结果进行了比较。

结果

16例患者在MR胆管造影和ERC检查中均未显示胆管扩张。在ERC检查中显示胆管扩张的29例患者中，MR胆管造影显示28例胆总管扩张。MR胆管造影有助于正确识别19例胆总管结石患者中的18例以及26例无胆总管结石患者中的22例。MR胆管造影的敏感性为95%，特异性为85%，阳性预测值为82%，阴性预测值为96%。2例假阳性结果是由于气胆所致。