胆囊作为贮存和浓缩胆汁的器官,其内的胆汁易于析出、凝集而形成结石。胆囊最常见的疾病多与结石相关,如胆石症、急慢性胆囊炎、胆囊癌等; 其他影响胆囊的病理状态还包括胆道动力障碍、术后改变等。超声对胆囊结石及胆囊炎的诊断有较高的敏感性及特异性,还可通过摄取高脂食物前后对比评价胆囊功能,是胆囊疾病的传统影像检查手段,但对肥胖患者其图像质量及解剖细节显示较差。目前,常规MRI已经成为重要的胆囊成像方法之一,并可引入经胆道排泄的造影剂进一步清晰显示其解剖及生理。对于超声不能很好评价的胆囊疾病患者应首选MRI检查。
ObjectiveTo evaluate the diagnostic value of CT, MRI, and magnetic resonance cholangiopancreatography (MRCP) in the localization and qualitative diagnosis of biliary obstruction.MethodsA total of 80 patients with biliary obstruction in our hospital from January 2018 to June 2020 were retrospectively collected. The patients were all examined by CT, MRI, and MRCP. The imaging images of all patients were interpreted by two radiologists with more than 5 years of working experience. Taking the results of operation and histopathology as the gold standard, the diagnostic value of CT, MRI+MRCP, CT+MRI+MRCP in the localization and qualitative diagnosis of biliary obstruction lesions were evaluated.ResultsCompared with the location results of surgery and histopathology, the coincidence rates of CT+MRI+MRCP and MRI+MRCP were higher than that of CT (P<0.05), but there was no significant difference between CT+MRI+MRCP and MRI+MRCP (P>0.05); compared with the benign and malignant results of surgery and histopathology, the coincidence rates of CT, CT+MRI+MRCP and MRI+MRCP were close, and there was no statistical significance among them (P>0.05).ConclusionsMRI+MRCP and CT+MRI+MRCP have the same value in the localization and qualitative diagnosis of biliary obstruction. However, MRI+MRCP have the advantages ofnon-radiation or contrast media, it is more suitable for patients who are worried about the impact of radiation, have contrast media allergy or renal insufficiency.