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

贾雷; 郭玉宁; 郭秀丽; 王天懿; 吕栋; 徐有青

doi:10.3969/j.issn.1001-5256.2016.09.024

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

DOI: 10.3969/j.issn.1001-5256.2016.09.024

首都医科大学附属北京天坛医院消化内科

基金项目:

基金项目:首都临床特色应用研究(Z131107002213025)；

详细信息

中图分类号: R575;R445
计量
- 文章访问数: 2345
- HTML全文浏览量: 23
- PDF下载量: 442
- 被引次数: 0
出版历程
- 出版日期: 2016-09-20

Value of endoscopic ultrasound and magnetic resonance cholangiopancreatography in diagnosis of obstructive jaundice

Department of Gastroenterology, Beijing Tiantan Hospital, Capital Medical University

Research funding:

摘要

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。
- 黄疸,阻塞性 /
- 腔内超声检查 /
- 胰胆管造影术,磁共振 /
- 诊断
Abstract:
Objective To investigate the value of endoscopic ultrasound( EUS) versus magnetic resonance cholangiopancreatography( MRCP) in the diagnosis of obstructive jaundice. Methods A 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. Results Of 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% and77. 40%,and Youden indices of 0. 90 and 0. 77. Conclusion EUS has a higher value in the diagnosis of obstructive jaundice than MRCP.
- jaundice,obstructive /
- endosonography /
- cholangiopancreatography,magnetic resonance /
- diagnosis

HTML全文

参考文献(13)

[1]HUANG P,ZHANG XF,ZHANG X,et al.A comparative study between combined and separate EUS and ERCP under anesthesia for pancreaticobiliary diseases[J].Chin J Dig Endosc,2013,30(12):675-677.(in Chinese)黄平,张筱凤,张啸,等.麻醉状态下内镜超声、胰胆管造影串联与分开诊治胆胰疾病的对比研究[J].中华消化内镜杂志,2013,30(12):675-677.

[2]MA XB,LI Y,ZHANG BB.Study on diagnosis value of MRCP for biliopancreatic obstruction disease[J].Chin J Med Offic,2014,42(8):789-792.(in Chinese)马晓兵,李瀛,张彬彬.磁共振胰胆管成像对阻塞性黄疸的诊断价值[J].临床军医杂志,2014,42(8):789-792.

[3]ZHANG Y,ZHU M,ZHANG M,et al.Value of endoscopic ultrasound in diagnosis of bile duct lesions in patients with a suspected diagnosis of biliary pancreatitis[J].Shandong Med J,2008,48(33):65-66.(in Chinese)张云,朱淼,张淼,等.超声内镜检查对疑诊胆源性胰腺炎患者胆管病变的诊断价值[J].山东医药,2008,48(33):65-66.

[4]XU LS,HU BD,LIANG DB.Value of endoscopic ultrasound versus magnetic resonance cholangiopancreatography in diagnosis of common bile duct stones:a comparative analysis[J/CD].Chin J Clinicians:Electronic Edition,2012,6(21):6876-6877.(in Chinese)徐林生,胡炳德,梁丁保.超声内镜和磁共振胰胆管造影对胆总管结石诊断价值的对比研究[J/CD].中华临床医师杂志:电子版,2012,6(21):6876-6877.

[5]WALLNER BK,SCHUMACHER KA,WEIDENMAIER W,et al.Dilated biliary tract:evaluation with MR cholangiography with a T2-weighted contrast-enhanced fast sequence[J].Radiology,1991,181(3):805-808.

[6]JIN ZD,LI ZS.Digestive endoscopic ultrasound[M].Beijing:Science Press,2011:3.(in Chinese)金震东,李兆申.消化超声内镜学[M].北京:科学出版社,2011:3.

[7]OH HC,SEO DW,SONGTJ,et al.Endoscopic ultrasonographyguided ethanol lavage with paclitaxel injection treats patients with pancreatic cysts[J].Gastroenterology,2011,140(1):172-179.

[8]POLISTINA FA,FREGO M,BISELLO M,et al.Accuracy of magnetic resonance cholangiography compared to operative endoscopy in detecting biliary stones,a single center experience and review of literature[J].World J Radiol,2015,7(4):70-78.

[9]ZOUHAIRI ME,WATSON JB,DESAI SV,et al.Rotational assisted endoscopic retrograde cholangiopancreatography in patients with reconstructive gastrointestinal surgical anatomy[J].World J Gastrointest Endosc,2015,7(3):278-282.

[10]YUE LY.Value of endoscopic ultrasound in diagnosis of digestive system diseases[J].Chin J Lab Diag,2014,18(3):475-477.(in Chinese)岳玲艳.超声内镜在消化系统疾病诊断中的应用[J].中国实验诊断学,2014,18(3):475-477.

[11]de CASTRO VL,MOURA EG,CHAVES DM,et al.Endoscopic ultrasound versus magnetic resonance cholangiopancreatography in suspected choledocholithiasis:a systematic review[J].Endosc Ultrasound,2016,5(2):118-128.

[12]WILLIAMS EJ,GREEN J,BECKINGHAM I,et al.Guidelines on the management of commom bile duct stones(CBDS)[J].Gut,2008,57(17):1004-1021.

[13]del POZO D,TABERNERO S,POVES E,et al.Usefulness of endoscopic ultrasonography in the clinical suspicion of biliary disease[J].Rev Esp Enferm Dig,2011,103(7):345-348.

施引文献

资源附件(0)

访问统计