【摘要】：目的 :回顧性分析經(jīng)內(nèi)鏡下逆行胰膽管造影(Endoscopic retrograde cholangiopancreatography,ERCP)確診的肝外膽管結(jié)石的3.0T MRI的影像特征,探討其漏診原因。方法:收集河北醫(yī)科大學(xué)第二醫(yī)院2009年6月—2014年10月56例同時(shí)行MRI(包含常規(guī)平掃及磁共振胰膽管水成像)及ERCP檢查的可疑肝外膽管結(jié)石患者,分析MRI圖像,并與ERCP結(jié)果對(duì)照。結(jié)果:3.0T MRI診斷肝外膽管結(jié)石的漏診率為30.23%(13/43)。將結(jié)石按最大徑劃分,5 mm為大結(jié)石,≤5 mm為小結(jié)石,其余近似流體樣結(jié)石為泥沙樣結(jié)石。其中泥沙樣結(jié)石的漏診率為100%,小結(jié)石的漏診率為30.77%,大結(jié)石的漏診率為12.5%,不同大小結(jié)石的漏診率之間有明顯差異(χ~2=15.938,P=0.0001),隨肝外膽管結(jié)石最大徑增大,MRI檢查漏診率下降。肝外膽管擴(kuò)張患者結(jié)石的漏診率為20%(6/30),肝外膽管不擴(kuò)張患者結(jié)石的漏診率為53.85%(7/13),肝外膽管擴(kuò)張和不擴(kuò)張患者的漏診率之間存在明顯差異(χ~2=4.926,P=0.026),肝外膽管不擴(kuò)張患者漏診率比肝外膽管擴(kuò)張患者高。結(jié)論 :3.0T MRI漏診肝外膽管結(jié)石受其大小、位置、膽管擴(kuò)張情況等多重因素影響。
[Abstract]:Aim: to analyze retrospectively the imaging features of 3.0 T MRI of extrahepatic bile duct stones diagnosed by endoscopic retrograde cholangiopancreatography (Endoscopic retrograde cholangiopancreatography,ERCP) and to explore the causes of missed diagnosis. Methods: from June 2009 to October 2014, 56 patients with suspected extrahepatic bile duct stones underwent MRI (including conventional plain scan and magnetic resonance cholangiopancreatography) and ERCP. The MRI images were analyzed. The results were compared with the results of ERCP. Results: the missed diagnosis rate of 3.0 T MRI diagnosis of extrahepatic bile duct stones was 30.23% (13 / 43). According to the maximum diameter, the calculi were classified as large stones at 5 mm, small stones with 鈮，

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