【摘要】 目的 探讨经内镜逆行胰胆管造影(ERCP)联合核磁共振(MRI)在急性胆源性胰腺炎(ABP)患者中的诊断效能。方法 选择2021年2月-2023年6月疑似急性胆源性胰腺炎患者119例为对象,入组病例均行ERCP和MRI检查,并以出院诊断结果作为“金标准”,分析ERCP、MRI及二者联合在急性胆源性胰腺炎患者中的阳性率及诊断效能(灵敏度与特异度)。结果 119例疑似急性胆源性胰腺炎患者出院前诊断74例阳性,阳性率为62.18%。MRI检查阳性61例,诊断准确率78.99%(94/119);ERCP检查阳性66例,诊断准确率84.87%(101/119);ERCP联合MRI检查阳性71例,诊断准确率为93.28%(111/119);不同检查方法阳性预测值无统计差异(P>0.05);ERCP联合MRI用于疑似急性胆源性胰腺炎中灵敏度、特异度与阴性预测值高于单一影像学检查(P<0.05)。结论 急性胆源性胰腺炎诊断时选择ERCP或MRI检查阳性率均较高,但是二者联合检查可获得较高的灵敏度与特异度,能辅助临床诊疗。更多还原

【Abstract】 Objective To explore the diagnostic efficacy of endoscopic retrograde cholangiopancreatography(ERCP) combined with magnetic resonance imaging(MRI) in patients with acute biliary pancreatitis(ABP). Methods 119 suspected patients with acute biliary pancreatitis from February 2021 to June 2023 were selected as the study subjects. All enrolled patients underwent ERCP and MRI examinations, and the discharge diagnosis results were used as the "gold standard" to analyze the positive rate and diagnostic efficacy(sensitivity and specificity) of ERCP, MRI, and their combination in patients with acute biliary pancreatitis. Results Among 119 suspected patients with acute biliary pancreatitis, 74 were diagnosed positive before discharge, with a positive rate of 62.18%. 61 cases were positive in MRI examination, with a diagnostic accuracy of 78.99%(94/119); 66 cases were positive for ERCP examination, with a diagnostic accuracy of 84.87%(101/119); 71 cases were positive in ERCP combined with MRI examination, with a diagnostic accuracy of 93.28%(111/119); There was no statistical difference in the positive predictive value between different examination methods(P>0.05); The sensitivity, specificity, and negative predictive value of ERCP combined with MRI in suspected acute biliary pancreatitis were higher than those of a single imaging examination(P<0.05). Conclusion The positive rate of ERCP or MRI in the diagnosis of acute biliary pancreatitis is relatively high, but the combination of the two can achieve high sensitivity and specificity, which can assist in clinical diagnosis and treatment.更多还原