Magnetic Resonance Cholangiopancreaticography as a Diagnostic Tool for Common Bile Duct Stones
Magnetic Resonance Cholangiopancreaticography as a Diagnostic Tool for Common Bile Duct Stones
复制标题
磁共振胰胆管造影作为胆总管结石的诊断工具
DOI：
10.1159/000068863
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发表时间：
2003
影响因子：
2.7
通讯作者：
E. Eddes
中科院分区：
文献类型：
--
作者：
J. Kats;M. Kraai;A. Dijkstra;K. Koster;F. Ter Borg;H. Hazenberg;M. Eeftinck Schattenkerk;B. G. Ziedses des Plantes;E. Eddes
背景/目的：磁共振胰胆管造影（MRCP）的诊断潜力随着技术的发展而提高。与内镜逆行胰胆管造影术（ERCP）相比，MRCP的发病率和死亡率可忽略不计。本研究旨在评价MRCP作为诊断性ERCP的替代品，以怀疑胆总管（CBD）结石。研究方法：从1998年到2001年，对202例根据病史（MH）、胆汁淤积性肝功能检查（CL）、MH和CL或其他原因怀疑胆总管结石的患者进行了MRCP。在所有MRCP显示存在CBD结石的患者中以及尽管MRCP阴性但临床上持续强烈怀疑CBD结石的患者中进行ERCP。结果：25例患者MRCP提示胆总管结石，24例经ERCP证实。尽管MRCP阴性，27例患者随后进行了ERCP。这些患者似乎都没有CBD结石。在该组中，MRCP检测CBD结石的敏感性为100%，特异性为96%。对所有患者的随访显示，另外5例患者持续存在临床怀疑或胆汁淤积性肝功能值。假设这些患者中存在CBD结石，MRCP对此诊断的敏感性为83%，特异性为99%。结论：在怀疑胆总管结石的情况下，MRCP应作为首选的诊断方法。
Background/Aims: The diagnostic potential of magnetic resonance cholangiopancreaticography (MRCP) has improved as a result of evolving technique. MRCP has the advantage of negligible morbidity and mortality in contrast to endoscopic retrograde cholangiopancreatography (ERCP). This study was performed to evaluate MRCP as a replacement for diagnostic ERCP for the suspicion of common bile duct (CBD) stones. Methods: From 1998 to 2001, MRCP was performed in 202 patients with a suspicion of CBD stones based on medical history (MH), cholestatic liver function tests (CL), both MH and CL or other reasons. ERCP was performed in all patients where MRCP indicated the presence of CBD stones and in those patients with a persistent strong clinical suspicion for CBD stones despite a negative MRCP. Results: In 25 patients, MRCP suggested CBD stones which were proven with ERCP in 24 patients. Despite a negative MRCP, 27 patients had a subsequent ERCP. None of these patients appeared to have CBD stones. In this group, MRCP resulted in 100% sensitivity and 96% specificity in detecting CBD stones. Follow-up of all patients revealed 5 more patients with persistent clinical suspicion or cholestatic liver function values. Assuming CBD stones in these patients, MRCP had a sensitivity of 83 % and a specificity of 99% for this diagnosis. Conclusion: In the case of CBD stone suspicion, MRCP should be the diagnostic procedure of choice.