Comparative diagnostic evaluation with ultrasonography, MSCT, MRCP and ERCP in patients with obstructive jaundice
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摘要: 目的比较内镜下逆行胰胆管造影(ERCP)与超声、多排螺旋CT(MSCT)及磁共振胰胆管造影(MRCP)对梗阻性黄疸的部位及病因诊断的准确率。方法 128例患者行超声、MSCT及ERCP检查,其中35例患者行MRCP检查。结果在梗阻部位的诊断上,四种方法对肝内胆管和胰头部的诊断准确率差异无统计学意义;ERCP对肝外胆管梗阻的诊断准确率与MRCP差异无统计学意义,但显著高于超声和MSCT;在病因诊断上,对于胆系结石、胆管炎和胰头癌的诊断准确率,四种方法差异无统计学意义;MRCP、ERCP和MSCT对于胆管癌诊断准确率均优于超声;此外,ERCP在诊断乳头部肿瘤、十二指肠乳头旁憩室时优于超声和MSCT。结论 ERCP对梗阻性黄疸的部位(尤其是肝外胆管和十二指肠乳头部)及病因(胆管癌、十二指肠乳头部肿瘤)的诊断具有重要价值。
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关键词:
- 黄疸,阻塞性 /
- 胰胆管造影术,内窥镜逆行 /
- 超声检查 /
- 体层投影术,螺旋计算机 /
- 胰胆管造影术,磁共振
Abstract: Objective To compare the diagnostic accuracy of endoscopic retrograde cholangiopancreatography (ERCP) with ultrasonography, multislice spiral computed tomography (MSCT) and magnetic resonance cholangiopancreatography (MRCP) on the location and etiology of obstructive jaundice.Methods 128 patients underwent ultrasonography, MSCT and ERCP, and 35 patients underwent MRCP.Results For the diagnosis of the location of obstructive jaundice, there is no significant difference found on evaluation of intrahepatic ducts and head of pancreas diagnosed by the four methods.Although ERCP has no significant difference with MRCP in investigating extrahepatic ducts but ERCP is superior to ultrasonography and MSCT.As for the etiology of obstructive jaundice, there is no significant difference found on evaluation for gallstone, cholangitis and carcinoma of the head of pancreas diagnosed by the four methods.MRCP, MSCT and ERCP were all better than ultrasonography for the diagnosis of cholangiocarcinoma, further more, ERCP was better than ultrasonography and MSCT for duodenal papilla cancer and juxtapapillary duodenal diverticula diagnosis. Conclusion ERCP has an important value in diagnosing the location (especially extrahepatic ducts, duodenal papilla) and etiology (especially cholangiocarcinoma and duodenal papilla cancer) of obstructive jaundice.-
Key words:
- jaundice /
- obstructive /
- cholangiopancreatography /
- endoscopic retrograde /
- ultrasonoyraphy
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[1]李兆申, 许国铭.ERCP基本技术与临床应用[M].第1版.济南:山东科学技术出版社, 2001. [2]Rogoveanu I, Gheonea DI, Saftoiu A, et al.The role of imagingmethods in identifying the causes of extrahepatic cholestasis[J].J Gastrointestin Liver Dis, 2006, 15 (3) :265-271. [3]Foley WD, Quiroz FA.The role of sonography in imaging of thebiliary tract[J].Ultrasound Quarterly, 2007, 23 (2) :123-135. [4]任粉玉, 朴熙绪, 崔顺子.ERCP在梗阻性黄疸病因鉴别诊断中的应用[J].世界华人消化杂志, 2009, 17 (28) :2955-2957. [5]刘永武, 朱英淮, 王士堂.B超联合磁共振胰胆管成像对梗阻性黄疸的诊断价值[J].实用肝脏病杂志, 2011, 14 (3) :207-208. [6]Chalya PL, Kanumba ES, McHembe M.Etiological spectrumand treatment outcome of obstructive jaundice at a universityteaching hospital in northwestern Tanzania:A diagnostic and-therapeutic challenges[J].BMC Res Notes, 2011, 23 (4) :147-154. [7]孟庆楷.经内镜逆行胰胆管造影术对梗阻性黄疸的诊断治疗价值[J].山西医药杂志, 2011, 40 (8) :782-783. [8]Fujita N.Endoscopic management of biliary malignancies[J].Gastrointest Endosc Clin N Am, 2008, 18 (3) :565-579. [9]Urbano M, Rosa A, Gomes D, et al.Team approach to ERCP-directed single-brush cytology for the diagnosis of malignancy[J].Rev Esp Enferm Dig, 2008, 100 (8) :462-465. [10]Wong JC, Lu DS.Staging of pancreatic adenocarcinoma byimaging studies[J].Clin Gastroenterol Hepatol, 2008, 6 (12) :1301-1308. [11]陈萍, 苏秉忠, 于金华, 等.ERCP检查对壶腹癌的诊断价值[J].中国内镜杂志, 2004, 10 (4) :85-87. [12]Maccioni F, Martinelli M, Al Ansari N, et al.Magnetic reso-nance cholangiography:past, present and future:a review[J].Eur Rev Med Pharmacol Sci, 2010, 14 (8) :721-725.
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