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.
[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.
|