MRCP 与 ERCP 对良恶性胆道梗阻的诊断价值对比

焦振华，孟致辉 * ，田治海，严朝雄，谭龙龙

咸阳市中心医院磁共振室，陕西 咸阳，712000

浏览次数：192次 下载次数：309次

摘要：

目的 比较 MRCP 与 ERCP 对梗阻后胰胆管解剖结构的显示能力，并探讨其对良恶性胆道梗阻的诊断价值。方法 回顾分析我院 124例胆道梗阻患者 MRCP和 ERCP的影像及临床资料。结果 MRCP对肝内 2级以上胆管、胆囊管、胆囊及主胰管的显示率显著高于 ERCP（P<0.05）；两种方法对左右肝管、肝总管、胆总管的显示率相当（P>0.05）。MRCP 和 ERCP 对恶性胆道梗阻诊断准确率分别为 78.95% 、86.84% ；对良性胆道梗阻诊断准确率分别为 88.37% 、93.02% ，差异不显著（P>0.05）。结论 MRCP对梗阻后胆胰管解剖结构显示优于ERCP，二者对良恶性胆道梗阻的诊断价值相当；其互补、联合应用对良恶性胆道梗阻有较高的诊治价值。

关键词： MRCP；ERCP；胆道梗阻

中图分类号： R445.2文献标志码：A文章编号： 2096-1413(2018)07-0144-02

Diagnostic value comparison of MRCP and ERCP in benign and malignant
obstruction of biliary tract



JIAO Zhen-hua,MENG Zhi-hui
*,TIAN Zhi-hai,YAN Zhao-xiong,TAN Long-long
(MRIRoom,XianyangCentralHospital,Xianyang712000,China)



ABSTRACT: Objective To compare the ability of MRCP and ERCP in demonstrate the anatomic structure ofobstruction of biliary tract,and to investigate the diagnostic value oftwo methods for benign and malignant biliary obstruction. Methods The imagingand clinical data of MRCP and ERCP in 124 patients with biliary obstruction were reviewed and analyzed. Results The displayrates of MRCP in intrahepatic bile ductabove grade 2,gallbladder,cysticgall ductand main pancreatieduct were significantly higher than those of ERCP (P<0.05);the display rates of ERCP in leftand righthepatic duct, hepaticduct,common bileduct were equivalent to MRCP (P>0.05).The diagnostic accuracy rates of MRCP and ERCP for malignant biliary obstruction were78.95% and 86.84% respectively; the diagnostic accuracy rates of MRCP and ERCP for benign biliary obstruction were 88.37% and 93.02% respectively;there were no statistical differences in the diagnosis of benign and malignant biliary obstruction between the two methods (P>0.05).Conclusion MRCP ismore satisfactory than ERCP in demonstrate the anatomic structure of obstruction ofbiliarytract.The two methods are of equalvaluein the diagnosis of benign and malignantbiliary obstruction.Ithas high value fordiagnosis and treatment of benign and malignant biliary obstruction bymutual supplement and combined application.  　                                

KEYWORDS: MRCP; ERCP; obstruction ofbiliarytract

参考文献：
[1]LIANG C,MAO H,W ANG Q,etal.Diagnostic performance ofmagnetic resonance cholangiopancreatography in malignant obstructivejaundice[J].CellBiochem Biophys,2011,61(2):383-388.
[2]KARKIS,JOSHIKS,REGMIS,etal.Role ofultrasound as comparedwith ERCP in patientwith obstructive jaundice[J].Kathmandu UnivMed J,2013,11(43):237-240.
[3] SINGH A,MANN HS,THUKRAL CL,et al.Diagnostic accuracy ofMRCP as compared to ultrasound/CT in patients with obstructiveJaundice[J].Clin Diagn Res,2014,8(3):103-107.
[4] 张昊 , 白鲜玲 , 伊生勇 , 等 . 联合应用 MRCP 和 ERCP 对胆管疾病诊疗价值的研究 [J]. 内蒙古医学杂志 ,2016,48(6):681-684.
[5]CHAN JH,TSUIEY,YUEN MK,etal.Gadopentetate dimeglumine asan oralnegative gastrointestinalcontrastagentfor MRCP[J].AbdomImaging,2000,25(4):405-408.
[6] GRUNNET M,MAU -SORENSEN M.Serum tumor markers in bileductcancer:areview[J].Biomarkers,2014,19(6):437-443.
[7] 王义 , 崔旭 , 臧建华 , 等 . 胆汁肿瘤标志物检测对于胆管远端良恶性狭窄鉴别诊断的价值 [J]. 现代消化及介入诊疗 ,2011,16(5):296-298.
[8] 王蒙 , 王广义 , 张平 , 等 . 诊断性 ERCP 在胆胰疾病中应用价值 [J]. 中国现代医学杂志 ,2012,22(13):95-98.
[9] 周文珍 , 顾建平 , 殷信道 , 等 .M SCT 、 MRCP 、 MRI 结合 MRCP 在诊断胆道梗阻性疾病中的应用比较 [J]. 中国医疗设备 ,2015,30(1):43-46.