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1、不同影像学检查方法在胆总管结石诊断中的应用【Abstract】Objective To study the different imaging examination method in the diagnosis of common bile duct calculi value.Methods Choose 82 cases of suspected patients with common bile duct calculi，respectively do B to exceed，magnetic resonance imaging（MRCP）and bile pancreatic du
2、ct by endoscopic retrograde pancreatic angiography（ERCP）examination，diagnosis criteria for ERCP，calculate the diagnostic sensitivity of ultrasound and MRCP，specific degree，positive predictive value and negative predictive value，contrast ultrasound and the accuracy of MRCP in the diagnosis of differe
3、nt size stones.Results 82 patients were successfully completed ERCP，among them 82 cases diagnosed with common bile duct calculi.Degree of B ultrasound in the diagnosis of sensitivity，specific and accuracy were 82.09%，66.67% and 79.27%，respectively.MRCP in the diagnosis of sensitivity，specific degree
4、s and accuracy of 91.04%，80.00% and 89.02% respectively.Ultrasound and the accuracy of MRCP in the diagnosis of1.0 cm diameter calculi were higher than the accuracy in diagnosiscalculi diagnosis accuracy is higher，and there exist limitations in tiny stones in diagnosis，clinical should be flexible to
5、 choose or combined use of different examination means，improve the diagnostic accuracy. 【Key words】Common bile duct stones；Ultrasonography；Magnetic resonance cholangiopancreatography；Retrograde cholangiopancreatography ?总管结石是胆道系统的常见病和多发病，随着人们生活水平和饮食结构的改变，其发病率呈现逐年上升趋势。胆总管结石的临床症状比较多，易导致胆源性胰腺炎、急性梗阻性化脓性胆管炎等并发症，严重时甚至死亡。术前准确诊断，充分了解患者胆道结构是否存在异常，掌握结石的数量、位置及大小，是决定手术方式的重要依据之一。随着影像学技术的发展，目前临床诊断胆总管结石的方法较多，包括超声、磁共振胆胰管成像（MRCP）及经内镜逆行性胰胆管造影（ERCP）等，其中ERCP是目前临床诊断的金标准，可同时用于诊断和治疗胆总管结石等胆道系统良性疾病1。本研究对82例胆总管结石症患者分别行B超和MRCP检查，并以ERCP检查和治疗结果为金标准，探讨不同检查方法的诊断价值，以期为临床胆总管结石的诊疗提供参考，现报告如下。 1 资料与方法 1.1 一般资料