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胆总管远端狭窄超声内镜特征分析

李鸿晔 韦亚蓉 李会会 丁浩 洪江龙 孟海轮 徐张巍 鲍峻峻 梅俏

李鸿晔,韦亚蓉,李会会,等. 胆总管远端狭窄超声内镜特征分析[J]. 临床肝胆病杂志, 2021, 37(11): 2632-2635. DOI: 10.3969/j.issn.1001-5256.2021.11.028
引用本文: 李鸿晔,韦亚蓉,李会会,等. 胆总管远端狭窄超声内镜特征分析[J]. 临床肝胆病杂志, 2021, 37(11): 2632-2635. DOI: 10.3969/j.issn.1001-5256.2021.11.028
LI HY, WEI YR, LI HH, et al. Endoscopic ultrasound features of distal biliary stricture[J]. J Clin Hepatol, 2021, 37(11): 2632-2635. DOI: 10.3969/j.issn.1001-5256.2021.11.028
Citation: LI HY, WEI YR, LI HH, et al. Endoscopic ultrasound features of distal biliary stricture[J]. J Clin Hepatol, 2021, 37(11): 2632-2635. DOI: 10.3969/j.issn.1001-5256.2021.11.028

胆总管远端狭窄超声内镜特征分析

DOI: 10.3969/j.issn.1001-5256.2021.11.028
基金项目: 

安徽省自然科学基金 2008085QH415

详细信息
    通讯作者:

    梅俏,meiqiao@hotmail.com

  • 中图分类号: R657.46

Endoscopic ultrasound features of distal biliary stricture

Research funding: 

Natural Science Foundation of Anhui Province 2008085QH415

  • 摘要:   目的  回顾性分析胆总管远端狭窄患者的超声内镜(EUS)特征,为EUS评估胆总管远端狭窄提供临床依据。  方法  收集安徽医科大学第一附属医院2016年4月—2020年3月行EUS检查的175例胆总管远端狭窄的患者临床资料,分析患者的临床表现、实验室、影像学及EUS检查结果,并进行随访,总结胆总管远端狭窄的EUS特征。计数资料两组间比较采用χ2检验,计量资料两组间比较采用t检验。  结果  175例胆总管远端狭窄患者中,良性胆总管远端狭窄85例(85/175,48.57%),恶性胆总管远端狭窄90例(90/175,51.43%)。在恶性胆总管远端狭窄的患者中,EUS显示狭窄长度高于良性胆总管远端狭窄患者[(14.1±3.0) mm vs (7.9±3.0) mm, t=13.358,P<0.001],同时EUS发现恶性胆总管远端狭窄患者的管腔低回声占位(57.8% vs 34.1%, χ2=9.843,P=0.002)、周围淋巴结肿大(26.7% vs 12.9%, χ2=5.147,P=0.023)及胰管扩张(51.1% vs 28.2%, χ2=9.532,P=0.002)等特征性改变发生率高于良性胆总管远端狭窄患者。EUS和MRCP两者联合诊断良性胆总管远端狭窄的敏感性为70.6%,诊断恶性胆总管远端狭窄的敏感性为92.2%。  结论  胆总管远端狭窄具有如较长狭窄、低回声、周围淋巴结肿大及胰管扩张等EUS图像特征,有助于临床中胆总管远端狭窄的鉴别诊断作用。

     

  • 表  1  胆总管远端狭窄的EUS特征分析

    EUS特征 良性胆总管远端狭窄(n=85) 恶性胆总管远端狭窄(n=90) 统计值 P
    狭窄段长度(mm) 7.9±3.0 14.1±3.0 t=13.358 <0.001
    不规则不均匀增厚[例(%)] 15(17.6) 25(27.8) χ2=2.544 0.111
    管腔低回声占位[例(%)] 29(34.1) 52(57.8) χ2=9.843 0.002
    周围淋巴结肿大[例(%)] 11(12.9) 24(26.7) χ2=5.147 0.023
    胰管扩张[例(%)] 24(28.2) 46(51.1) χ2=9.532 0.002
    十二指肠乳头占位[例(%)] 13(15.3) 18(20.0) χ2=0.664 0.415
    壶腹部占位[例(%)] 16(18.8) 19(21.1) χ2=0.143 0.705
    下载: 导出CSV

    表  2  EUS、MRCP对胆总管远端狭窄的诊断效能

    疾病分类 诊断方法 敏感度(%) 特异度(%) 阳性预测值(%) 阴性预测值(%)
    良性胆总管远端狭窄 EUS 52.9 80.0 71.4 64.3
    MRCP 34.1 81.1 63.0 56.6
    两者联合 70.6 65.6 66.7 70.2
    恶性胆总管远端狭窄 EUS 72.2 74.1 74.7 71.6
    MRCP 60.0 95.3 93.1 69.2
    两者联合 92.2 71.8 77.6 89.7
    下载: 导出CSV
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  • 收稿日期:  2021-03-17
  • 录用日期:  2021-06-13
  • 出版日期:  2021-11-20
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