【摘要】 目的:探讨超声内镜(EUS)在经内镜逆行胰胆管造影(ERCP)术前诊断胆总管细小结石中的临床价值。方法:回顾性分析2018年1-12月本院拟行ERCP取石术的疑似胆总管结石、并在术前行EUS或MRCP的80例患者的临床资料。将ERCP术前行EUS的31例患者设为EUS组,行MRCP的49例患者设为MRCP组。分析两组患者的临床资料,比较两种检查方式对直径≥10 mm或<10 mm胆总管结石的敏感度、特异度、准确度。结果:EUS检查敏感度、特异度、准确度均明显高于MRCP检查,差异均有统计学意义(P<0.05)。EUS检查对直径<10 mm的胆总管结石敏感度、准确度均明显高于MRCP检查,差异均有统计学意义(P<0.05)。两种检查方式对直径≥10 mm的胆总管结石敏感度、特异度、准确度比较,差异均无统计学意义(P>0.05)。结论:EUS在ERCP术前诊断胆总管细小结石能显著提高敏感度、特异度、准确度,值得临床推广应用。更多还原

【Abstract】 Objective:To investigate the clinical value of endoscopic ultrasonography (EUS) in the diagnosis of small calculi in common bile duct before endoscopic retrograde cholangiopancreatography (ERCP).Method:The clinical data of 80 patients with suspected choledocholithiasis undergoing ERCP lithotomy and preoperative EUS or MRCP in our hospital from January to December 2018 were retrospectively analyzed.31 patients with EUS before ERCP were set as EUS group and 49 patients with MRCP were set as MRCP group.The clinical data of the two groups were analyzed,the sensitivity,specificity and accuracy of the two methods for choledocholithiasis with diameter ≥10 mm or <10 mm were compared.Result:The sensitivity,specificity and accuracy of EUS were significantly higher than those of MRCP,the differences were statistically significant (P<0.05).The sensitivity and accuracy of EUS for choledocholithiasis <10 mm in diameter were significantly higher than MRCP,the differences were statistically significant (P<0.05).There were no statistically significant differences in sensitivity,specificity and accuracy between the two methods for choledocholithiasis with diameter ≥10 mm (P>0.05).Conclusion:EUS can significantly improve the sensitivity,specificity and accuracy in the diagnosis of common bile duct fine calculi before ERCP,which is worthy of clinical application.更多还原