磁共振胰胆管成像联合CT动态增强诊断胆道狭窄性质的价值
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摘要
目的探讨磁共振胆胰管造影(MRCP)联合CT动态增强(DCE-CT)在胆道狭窄性质诊断方面的有效性和准确度。方法选取100例胆道狭窄疾病的患者分为良性胆道狭窄(48例)组和恶性胆道狭窄(52例)组。比较2组狭窄段胆管壁厚、长度、内径,狭窄段上方胆管扩张程度以及狭窄段管壁强化程度等相关指标,将各指标进行单独及联合诊断,分析其鉴别胆道狭窄性质的准确性。结果 Logistic回归分析显示,狭窄段壁厚、狭窄段管径、门静脉期狭窄段管壁强化程度和延迟期狭窄段管壁强化程度对恶性胆道狭窄的发生存在影响(P<0.05)。4项指标联合诊断良恶性胆道狭窄的AUC最高,为0.965,95%CI为0.907～0.991,敏感性86.54%,特异性93.75%。结论狭窄段胆管壁厚、管径,门静脉期、延迟期狭窄段管壁强化程度4项指标的联合能有效鉴别胆道狭窄的良恶性。
Objective To investigate the validity and accuracy of magnetic resonance cholangiopancreatograph(MRCP)combined with dynamic contrast enhanced CT(DCE-CT) in the diagnosis of biliary stricture. Methods One hundred patients with biliary stricture were enrolled and divided into benign biliary stricture(48 cases) and malignant biliary stricture(52 cases). The biliary wall thickness, length, inner diameter, biliary dilatation degree above the stenosis segment and the degree of stenosis of the stenosis were compared. The indexes were analyzed separately and combined to analyze the accuracy of the biliary stricture. Results Logistic regression analysis showed that the wall thickness of the stenosis, the diameter of the stenosis, the enhancement of the wall of the stenosis of the portal vein and the degree of enhancement of the stenosis of the stenosis had an effect on the occurrence of malignant biliary stricture(P <0.05). The combination of four indicators for the diagnosis of benign and malignant biliary stricture had the highest AUC(0.965). The 95% CI was 0.907-0.991. The sensitivity was 86.54%, and specificity was 93.75%. Conclusion The combination of biliary wall thickness, diameter, portal vein and delayed stenosis can effectively differentiate the benign and malignant biliary stricture.
Objective To investigate the validity and accuracy of magnetic resonance cholangiopancreatograph(MRCP)combined with dynamic contrast enhanced CT(DCE-CT) in the diagnosis of biliary stricture. Methods One hundred patients with biliary stricture were enrolled and divided into benign biliary stricture(48 cases) and malignant biliary stricture(52 cases). The biliary wall thickness, length, inner diameter, biliary dilatation degree above the stenosis segment and the degree of stenosis of the stenosis were compared. The indexes were analyzed separately and combined to analyze the accuracy of the biliary stricture. Results Logistic regression analysis showed that the wall thickness of the stenosis, the diameter of the stenosis, the enhancement of the wall of the stenosis of the portal vein and the degree of enhancement of the stenosis of the stenosis had an effect on the occurrence of malignant biliary stricture(P <0.05). The combination of four indicators for the diagnosis of benign and malignant biliary stricture had the highest AUC(0.965). The 95% CI was 0.907-0.991. The sensitivity was 86.54%, and specificity was 93.75%. Conclusion The combination of biliary wall thickness, diameter, portal vein and delayed stenosis can effectively differentiate the benign and malignant biliary stricture.
引文
[1]张宏昭,任利.良恶性胆道狭窄的临床诊断现状[J].世界最新医学信息文摘:连续型电子期刊,2015,(67):32-32.
[2]史彬,刘影,曾飞雁,等.磁共振胆胰管造影联合增强CT对良恶性胆道狭窄的鉴别价值[J].中国医学影像学杂志,2015,23(8):597-601,613.
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[4]龚志高.磁共振胆胰管造影联合增强CT对良恶性胆道狭窄的鉴别[J].现代医用影像学,2017,26(6):1678-1679.
[5]张丽.磁共振胆胰管造影联合增强CT对良恶性胆道狭窄检出率的影响[J].现代医用影像学,2017,26(6):1735-1737.
[6]隋静,孙金山,聂占国.ERCP在胆道术后胆管良性狭窄中的应用[J].西北国防医学杂志,2016,(3):185-187.
[7]梁宾勇,黄志勇,张尊义,等.肝门部胆管良性狭窄的病因、诊断及治疗[J].腹部外科,2016,29(5):327-330.
[8]曾永毅,黄新辉.肝胆管结石合并胆道感染的诊断及处理[J].中国实用外科杂志,2016,36(3):295-299.
[9]刘建辉,刘欣然.磁共振胆胰管造影联合增强CT对良恶性胆道狭窄的鉴别分析[J].中国继续医学教育,2016,8(15):50-51.
[10]李少军.探究磁共振胆胰管造影联合增强CT在良恶性胆道狭窄鉴别中的应用价值[J].人人健康,2016,(24):275.
[11]方卫平,许国强,于红静.IDUS、CT和MRCP对胆道恶性梗阻的诊断价值[J].浙江医学,2016,38(3):201-204.
[12]殷赵华.MRCP在胆道疾病诊断中的应用价值[J].中国卫生标准管理,2016,7(24):166-167.
[13]Den AD,Wasser MN,Willemssen FE,et al.Value of magnetic resonance cholangiopancreatography in assessment of nonanastomotic biliary strictures after liver transplantation[J].Transplant Direct,2015,1(10):e42.
[2]史彬,刘影,曾飞雁,等.磁共振胆胰管造影联合增强CT对良恶性胆道狭窄的鉴别价值[J].中国医学影像学杂志,2015,23(8):597-601,613.
[3]吕文武.磁共振胆胰管造影联合增强CT对良恶性胆道狭窄的鉴别价值分析[J].中国农村卫生,2017,(20):46.
[4]龚志高.磁共振胆胰管造影联合增强CT对良恶性胆道狭窄的鉴别[J].现代医用影像学,2017,26(6):1678-1679.
[5]张丽.磁共振胆胰管造影联合增强CT对良恶性胆道狭窄检出率的影响[J].现代医用影像学,2017,26(6):1735-1737.
[6]隋静,孙金山,聂占国.ERCP在胆道术后胆管良性狭窄中的应用[J].西北国防医学杂志,2016,(3):185-187.
[7]梁宾勇,黄志勇,张尊义,等.肝门部胆管良性狭窄的病因、诊断及治疗[J].腹部外科,2016,29(5):327-330.
[8]曾永毅,黄新辉.肝胆管结石合并胆道感染的诊断及处理[J].中国实用外科杂志,2016,36(3):295-299.
[9]刘建辉,刘欣然.磁共振胆胰管造影联合增强CT对良恶性胆道狭窄的鉴别分析[J].中国继续医学教育,2016,8(15):50-51.
[10]李少军.探究磁共振胆胰管造影联合增强CT在良恶性胆道狭窄鉴别中的应用价值[J].人人健康,2016,(24):275.
[11]方卫平,许国强,于红静.IDUS、CT和MRCP对胆道恶性梗阻的诊断价值[J].浙江医学,2016,38(3):201-204.
[12]殷赵华.MRCP在胆道疾病诊断中的应用价值[J].中国卫生标准管理,2016,7(24):166-167.
[13]Den AD,Wasser MN,Willemssen FE,et al.Value of magnetic resonance cholangiopancreatography in assessment of nonanastomotic biliary strictures after liver transplantation[J].Transplant Direct,2015,1(10):e42.