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超声内镜与磁共振胰胆管造影诊断梗阻性黄疸的效果比较
Value of endoscopic ultrasound and magnetic resonance cholangiopancreatography in diagnosis of obstructive jaundice
文章发布日期:2016年08月08日  来源:  作者:贾 雷, 郭玉宁, 郭秀丽, 等  点击次数:1258次  下载次数:229次

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【摘要】:目的对比超声内镜(EUS)与磁共振胰胆管造影(MRCP)对梗阻性黄疸的诊断价值。方法收集2015年1月-2016年3月于首都医科大学附属北京天坛医院就诊的梗阻性黄疸患者31例,所有患者均行EUS、MRCP检查,比较EUS、MRCP诊断梗阻性黄疸的敏感度、特异度、准确度、Youden指数。结果31例患者中胆总管结石16例(51.61%),壶腹肿瘤1例(3.23%),十二指肠乳头肿瘤6例(19.35%),胰头肿瘤3例(9.68%),胆管肿瘤2例(6.45%),胆管炎症2例(6.45%),1例(3.23%)经内镜逆行胰胆管造影、EUS、MRCP均未见结石、占位。对壶腹肿瘤、十二指肠乳头肿瘤、胰头肿瘤EUS诊断符合率均为100%;MRCP的胆总管结石诊断符合率、总诊断符合率均低于EUS(81.25% vs 93.75%,76.67% vs 90.00%)。EUS和MRCP诊断梗阻性黄疸的敏感度分别为90.00%和76.70%,特异度均为100%,准确度分别为90.30%和77.40%,Youden指数分别为0.90和0.77。结论对于梗阻性黄疸的诊断,EUS较MRCP拥有更高的诊断价值。
【Abstract】:ObjectiveTo investigate the value of endoscopic ultrasound (EUS) versus magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of obstructive jaundice. MethodsA total of 31 patients with obstructive jaundice who visited Beijing Tiantan Hospital, Capital Medical University, from January 2015 to March 2016 were enrolled, and all the patients underwent EUS and MRCP. The sensitivity, specificity, accuracy, and Youden index of EUS and MRCP in the diagnosis of obstructive jaundice were compared. ResultsOf all patients, 16 (51.61%) were diagnosed with common bile duct stones, 1 (3.23%) was diagnosed with ampullary tumor, 6 (19.35%) were diagnosed with duodenal papillary tumor, 3 (9.68%) were diagnosed with tumor of the head of the pancreas, 2 (6.45%) were diagnosed with bile duct tumor, 2 (6.45%) were diagnosed with bile duct inflammation, and 1 had no stones or space-occupying lesions observed by endoscopic retrograde cholangiopancreatography, EUS, or MRCP. The coincidence rate of EUS in the diagnosis of ampullary tumor, duodenal papillary tumor, and tumor of the head of the pancreas was 100%, and MRCP had a lower coincidence rate in the diagnosis of common bile duct stones and a lower overall coincidence rate of diagnosis than EUS (81.25%/76.67% vs 93.75%/90.00%). In the diagnosis of obstructive jaundice, EUS and MRCP had sensitivities of 90.00% and 76.70%, specificities of 100%, accuracy rates of 90.30% and 7740%, and Youden indices of 0.90 and 0.77. ConclusionEUS has a higher value in the diagnosis of obstructive jaundice than MRCP.
【关键字】:黄疸, 阻塞性; 腔内超声检查; 胰胆管造影术, 磁共振; 诊断
【Key words】:jaundice, obstructive; endosonography; cholangiopancreatography, magnetic resonance; diagnosis
【引证本文】:贾雷, 郭玉宁, 郭秀丽, 等. 超声内镜与磁共振胰胆管造影诊断梗阻性黄疸的效果比较[J]. 临床肝胆病杂志, 2016, 32(9): 1753-1755.

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