【摘要】 目的评价磁共振胰胆管造影(MRCP)结合MRI图像检查在胆总管相对探查指征患者中的应用价值。方法104例具备胆总管相对探查指征患者均行MRCP及MRI图像检查,检查结果由两位富有经验的影像学专家判定;确定性诊断依据术中胆总管探查结果、临床随访及其他影像学检查而定。结果59例(56.7%)患者避免了术中行胆总管探查术,这些患者中5例(4.8%)诊断为其他疾病;依据MRCP和MRI图像检查结果,得到适当治疗患者占84.6%(88/104);MRCP结合MRI图像检查诊断胆总管结石的敏感性、特异性、阳性预测值及阴性预测值分别为96.7%、98.5%、96.7%、98.5%,Kappa系数为0.9。结论MRCP结合MRI图像检查能够有效筛选需行胆总管探查患者,降低胆总管探查的阴性率。更多还原

【Abstract】 Objective To evaluate the Magnetic Resonance Cholangiopancreatography (MRCP) combined with Nuclear Magnetic Resonance Imaging (MRI source images in the management of patients with relative indication of common bile duct exploration (CBDE).Methods One hundred and four consecutive patients with relative indication of CBDE were explored by MRCP+MRI source images.All the findings were interpreted by two experienced radiologists.The definitive diagnosis was established by intraoperative CBDE,clinical follow-up and other investigations of imaging examination.Results The unnecessary intraoperative CBDE was avoided in 59 patients (56.7%),among them 5 cases (4.8%) were diagnosed as having other diseases.Basing on the results of MRCP+MRI source images,the patients who got appropriate management accounted for 84.6% (88/104).The sensitivity,specificity and positive and negative predictive values of MRCP+MRI source images for the diagnosis of common bile duct stones were 96.7%,98.5%,96.7%,98.5% respectively,with an excellent inter-observer agreement (kappa=0.9).Conclusion MRCP+MRI source images can be used to efficiently screen patients who may need further invasive exploration of the common bile duct and decrease the negative rate of intraoperative CBDE.更多还原