Loading [MathJax]/extensions/MathZoom.js
中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

彩超初诊为胆囊结石患者行磁共振胰胆管造影的必要性及指征分析

祝佩瑶 杨军 杨勇 韩亚东 庄磊 韩咏

祝佩瑶, 杨军, 杨勇, 韩亚东, 庄磊, 韩咏. 彩超初诊为胆囊结石患者行磁共振胰胆管造影的必要性及指征分析[J]. 临床肝胆病杂志, 2019, 35(6): 1293-1298. DOI: 10.3969/j.issn.1001-5256.2019.06.022.
引用本文: 祝佩瑶, 杨军, 杨勇, 韩亚东, 庄磊, 韩咏. 彩超初诊为胆囊结石患者行磁共振胰胆管造影的必要性及指征分析[J]. 临床肝胆病杂志, 2019, 35(6): 1293-1298. DOI: 10.3969/j.issn.1001-5256.2019.06.022.
Zhu PeiYao, Yang Jun, Yang Yong, Han YaDong, Zhuang Lei, Han Yong. Necessity of magnetic resonance cholangiopancreatography in patients with initial diagnosis of gallstones on color Doppler ultrasound and an analysis of related indications[J]. J Clin Hepatol, 2019, 35(6): 1293-1298. DOI: 10.3969/j.issn.1001-5256.2019.06.022.
Citation: Zhu PeiYao, Yang Jun, Yang Yong, Han YaDong, Zhuang Lei, Han Yong. Necessity of magnetic resonance cholangiopancreatography in patients with initial diagnosis of gallstones on color Doppler ultrasound and an analysis of related indications[J]. J Clin Hepatol, 2019, 35(6): 1293-1298. DOI: 10.3969/j.issn.1001-5256.2019.06.022.

彩超初诊为胆囊结石患者行磁共振胰胆管造影的必要性及指征分析

DOI: 10.3969/j.issn.1001-5256.2019.06.022
详细信息
  • 中图分类号: R657.42;R445

Necessity of magnetic resonance cholangiopancreatography in patients with initial diagnosis of gallstones on color Doppler ultrasound and an analysis of related indications

  • 摘要: 目的探讨临床上彩超初诊为胆囊结石患者行磁共振胰胆管造影(MRCP)的必要性及指征。方法采用回顾性病例对照研究方法,收集了2013年1月-2017年12月徐州医科大学附属医院收治的1431例以胆囊结石首诊入院患者的临床病例资料。入院时,腹部彩超均只发现胆囊结石,未发现其他病变。最终经过手术治疗后,诊断为单纯胆囊结石患者为对照组,合并有胆总管结石患者为实验组。通过logistic回归分析,建立"胆囊结石合并胆总管结石"的相关预测模型,并最终绘制预测模型及各个指标的受试者工作特征曲线(ROC曲线),计算曲线下面积。结果经过logistic分析筛选的4项指标为:胆总管扩张(χ1)、胆囊增大(χ2)、DBil(χ3)、GGT(χ4),建立的logistic回归模型为:Logit(P)=-4. 153+3. 592χ1+1. 720χ2+1. 798χ3+1. 519χ4。模型对于彩超漏诊胆总管结石的敏感度为53. 4%,特...

     

  • [1]WILLIAMS E, BECKINGHAM I, EL SAYED G, et al.Updated guideline on the management of common bile duct stones (CBDS) [J].Gut, 2017, 66 (5) :765-782.
    [2]OGURA T, HIGUCHI K.A review of treatment options for bile duct stones[J].Expert Rev Gastroenterol Hepatol, 2016, 10 (11) :1271-1278.
    [3]CHEN GF, LU XL, LI JH, et al.Clinical effects of two surgical procedures in treatment of gallstones complicated by common bile duct stones:A comparative analysis[J].J Clin Hepatol, 2017, 33 (2) :300-303. (in Chinese) 陈高飞, 芦小龙, 李剑辉, 等.两种微创术式治疗胆囊结石合并胆总管结石的效果比较[J].临床肝胆病杂志, 2017, 33 (2) :300-303.
    [4]QIU Y, YANG Z, LI Z, et al.Is preoperative MRCP necessary for patients with gallstones?An analysis of the factors related to missed diagnosis of choledocholithiasis by preoperative ultrasound[J].BMC Gastroenterol, 2015, 15:158.
    [5]ZANG J, YUAN Y, ZHANG C, et al.Elective laparoscopic cholecystectomy without intraoperative cholangiography:Role of preoperative magnetic resonance cholangiopancreatography-a retrospective cohort study[J].BMC Surg, 2016, 16 (1) :45.
    [6]WANG H, ZHAO W, QIU XP, et al.Routine MRCP examination for patients with gallbladder stone row to explore the value of the LC before the operation[J].China Foreign Med Treatment, 2016, 35 (19) :188-189. (in Chinese) 王华, 赵伟, 邱玺鹏, 等.常规MRCP检查用于胆囊结石患者行LC手术前的价值探讨[J].中外医疗, 2016, 35 (19) :188-189.
    [7]European Association for the Study of the Liver.EASL clinical practice guidelines on the prevention, diagnosis and treatment of gallstones[J].J Hepatol, 2016, 65 (1) :146-181.
    [8]de SOUSA S, TOBLER O, IRANMANESH P, et al.Management of suspected common bile duct stones on cholangiogram during same-stay cholecystectomy for acute gallstone-related disease[J].BMC Surg, 2017, 17 (1) :39.
    [9]WANG YC, ZHANG WL, WANG XH, et al.A review of the risk factors for cholelithiasis in China[J].Chin J Mult Organ Dis Eld, 2018, 17 (8) :636-640. (in Chinese) 王云超, 张维璐, 王新华.我国胆石病相关危险因素概述[J].中华老年多器官疾病杂志, 2018, 17 (8) :636-640.
    [10]HUNG SC, LIAO KF, LAI SW, et al.Risk factors associated with symptomatic cholelithiasis in Taiwan:A populationbased study[J].BMC Gastroenterol, 2011, 11:111.
    [11]WARTTIG S, WARD S, ROGERS G, et al.Diagnosis and management of gallstone disease:Summary of NICE guidance[J].BMJ, 2014, 349:g6241.
    [12]GURUSAMY KS, GILJACA V, TAKWOINGI Y, et al.Ultrasound versus liver function tests for diagnosis of common bile duct stones[J].Cochrane Database Syst Rev, 2015, (2) :CD011548.
    [13]MORRIS S, GURUSAMY KS, SHERINGHAM J, et al.Costeffectiveness analysis of endoscopic ultrasound versus magnetic resonance cholangiopancreatography in patients with suspected common bile duct stones[J].PLo S One, 2015, 10 (3) :e0121699.
    [14]ERCP Group, Chinese Society of Digestive Endoscopology;Biliopancreatic Group, Chinese Association of Gastroenterologist and Hepatologist, National Clinical Research Center for Digestive Diseases.Chinese guidelines for ERCP (2018) [J].J Clin Hepatol, 2018, 34 (12) :2537-2554. (in Chinese) 中华医学会消化内镜学分会ERCP学组, 中国医师协会消化医师分会胆胰学组, 国家消化系统疾病临床医学研究中心.中国经内镜逆行胰胆管造影术指南 (2018版) [J].临床肝胆病杂志, 2018, 34 (12) :2537-2554.
    [15]PICKUTH D.Radiologic diagnosis of common bile duct stones[J].Abdom Imaging, 2014, 25 (6) :618-621.
    [16]KANG J, PAIK KH, LEE JC, et al.The efficacy of clinical predictors for patients with intermediate risk of choledocholithiasis[J].Digestion, 2016, 94 (2) :100-105.
    [17]HJARTARSON JH, HANNESSON P, SVERRISSON I, et al.The value of magnetic resonance cholangiopancreatography for the exclusion of choledocholithiasis[J].Scand J Gastroenterol, 2016, 51 (10) :1249-1256.
    [18]NODA Y, GOSHIMA S, KOJIMA T, et al.Improved diagnosis of common bile duct stone with single-shot balanced turbo field-echo sequence in MRCP[J].Abdom Radiol (NY) , 2017, 42 (4) :1183-1188.
    [19]PENG WK, SHEIKH Z, PATERSON-BROWN S, et al.Role of liver function tests in predicting common bile duct stones in acute calculous cholecystitis[J].Br J Surg, 2005, 92 (10) :1241-1247.
    [20]AHN KS, YOON YS, HAN HS, et al.Use of liver function tests as first-line diagnostic tools for predicting common bile duct stones in acute cholecystitis patients[J].World J Surg, 2016, 40 (8) :1925-1931.
    [21]VIDEHULT P, SANDBLOM G, RUDBERG C, et al.Are liver function tests, pancreatitis and cholecystitis predictors of common bile duct stones?Results of a prospective, populationbased, cohort study of 1171 patients undergoing cholecystectomy[J].HPB (Oxford) , 2011, 13 (8) :519-527.
    [22]ZARE M, KARGAR S, AKHONDI M, et al.Role of liver function enzymes in diagnosis of choledocholithiasis in biliary colic patients[J].Acta Med Iran, 2011, 49 (10) :663-666.
    [23]KANG SK, HOFFMAN D, FERKET B, et al.Risk-stratified versus non-risk-stratified diagnostic testing for management of suspected acute biliary obstruction:Comparative effectiveness, costs, and the role of MR cholangiopancreatography[J].Radiology, 2017, 284 (2) :468-481.
    [24]HE H, TAN C, WU J, et al.Accuracy of ASGE high-risk criteria in evaluation of patients with suspected common bile duct stones[J].Gastrointest Endosc, 2017, 86 (3) :525-532.
    [25]KOO KP, TRAVERSO LW.Do preoperative indicators predict the presence of common bile duct stones during laparoscopic cholecystectomy?[J].Am J Surg, 1996, 171 (5) :495-499.
    [26]HUNT DR.Common bile duct stones in non-dilated bile ducts?An ultrasound study[J].Australas Radiol, 1996, 40 (3) :221-222.
    [27]YANG MH, CHEN TH, WANG SE, et al.Biochemical predictors for absence of common bile duct stones in patients undergoing laparoscopic cholecystectomy[J].Surg Endosc, 2008, 22 (7) :1620-1624.
    [28]GU J, TU K, WANG F, et al.Diagnostic value of serum liver function indexes for gallbladder stones combined with asymptomatic secondary common bile duct stones[J].Chin J Dig Surg, 2017, 16 (2) :183-187. (in Chinese) 顾进, 涂奎, 王芳, 等.血清肝功能指标对胆囊结石合并无症状继发性胆总管结石的诊断价值[J].中华消化外科杂志, 2017, 16 (2) :183-187.
    [29]RAHAL MA, RAMMAL MO, KARAOUI W, et al.Predictors of bile tree pathology in patients presenting with gallbladder disease[J].Eur J Gastroenterol Hepatol, 2017, 29 (9) :1017-1021.
    [30]BOURGOUIN S, TRUCHET X, LAMBLIN G, et al.Dynamic analysis of commonly used biochemical parameters to predict common bile duct stones in patients undergoing laparoscopic cholecystectomy[J].Surg Endosc, 2017, 31 (11) :4725-4734.
    [31]RIGGLE AJ, CRIPPS MW, LIU L, et al.An analysis of omitting biliary tract imaging in 668 subjects admitted to an acute care surgery service with biochemical evidence of choledocholithiasis[J].Am J Surg, 2015, 210 (6) :1140-1144;discussion1144-1146.
  • 期刊类型引用(12)

    1. 何倩倩,邵国良. 螺旋CT与超声在胆道系统急腹症中的临床应用与价值分析. 浙江临床医学. 2024(02): 261-263 . 百度学术
    2. 吴健. 腹腔镜联合胆道镜在胆管结石合并胆囊结石患者中的应用价值. 黔南民族医专学报. 2024(01): 64-67 . 百度学术
    3. 庞彦蕊,张春花,楚明垒. 超声在胆总管结石诊断中的应用价值. 临床医学. 2022(01): 93-95 . 百度学术
    4. 滕廷鹏. 胆囊结石伴隐匿性胆总管结石的危险因素分析. 医学研究杂志. 2022(01): 103-107 . 百度学术
    5. 蔡文静,程南生,金张龙. 胆囊结石合并胆囊炎患者MRCP表现及其诊断价值. 中国医药导报. 2022(04): 153-156 . 百度学术
    6. 张蕾. 彩超和MRCP诊断胆总管结石临床应用价值探讨. 中国医药指南. 2022(27): 65-68 . 百度学术
    7. 范海静. 彩超与磁共振胰胆管成像诊断胆总管结石的临床价值. 当代医学. 2021(05): 80-82 . 百度学术
    8. 洪杰,蔡琦,崔巍. 3.0T MRCP联合腹部彩超在可疑胆囊结石诊断中的应用价值. 中国医药导报. 2021(19): 159-162 . 百度学术
    9. 阳桃. 腹部彩超联合磁共振胰胆管造影对胆总管结石诊断的价值探讨. 影像研究与医学应用. 2020(14): 116-118 . 百度学术
    10. 李雪梅. 胆总管末段结石的彩色超声诊断效果探讨. 影像研究与医学应用. 2020(17): 131-132 . 百度学术
    11. 杨生洪. 评估磁共振胆胰管成像对阻塞性黄疸的临床诊断价值. 当代医学. 2020(26): 181-182 . 百度学术
    12. 高天玲. 腹部彩超在胆总管结石诊断中的临床价值观察. 影像研究与医学应用. 2020(24): 143-145 . 百度学术

    其他类型引用(1)

  • 加载中
计量
  • 文章访问数:  1718
  • HTML全文浏览量:  73
  • PDF下载量:  260
  • 被引次数: 13
出版历程
  • 收稿日期:  2018-12-19
  • 出版日期:  2019-06-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回