多层螺旋 CT 联合磁共振胰胆管成像检查诊断胆道梗阻性疾病的研究

肝脏 ›› 2025, Vol. 30 ›› Issue (3): 391-394.

多层螺旋 CT 联合磁共振胰胆管成像检查诊断胆道梗阻性疾病的研究

冯巍, 王兆清

215000 江苏苏州大学附属儿童医院放射科

收稿日期:2024-12-12 出版日期:2025-03-31 发布日期:2025-06-16
通讯作者: 王兆清,Email: 14536916@qq.com
基金资助:
苏州市“科教兴卫”青年科技项目(KJXW2022080)

Diagnostic value of MDCT combined with MRCP in biliary obstructive diseases in infants and toddlers

FENG Wei, WANG Zhao-qing

Department of Radiology, Children's Hospital Affiliated to Soochow University, Jiangsu 215000, China

Received:2024-12-12 Online:2025-03-31 Published:2025-06-16
Contact: WANG Zhao-qing,Email:14536916@qq.com

摘要/Abstract

摘要： 目的探讨多层螺旋 CT(MDCT)联合磁共振胰胆管成像(MRCP)在婴幼儿胆道梗阻性疾病中的诊断价值。方法回顾性收集苏州大学附属儿童医院于2021年1月—2024年1月收治的胆道梗阻类疾病患儿的临床资料,所有患儿均经胆道造影检查和术后病理检查确诊后,将其中47例囊肿型胆道闭锁(CBA)患儿设为CBA组,42例胆总管囊肿(CC)患儿设为CC组。对比两组患儿术前MDCT 和MRCP的检查结果,并通过ROC曲线评估其诊断效能。结果 CBA组患儿白陶土样大便占比为21.28%(10/47),高于CC组的0.00%,CBA组总胆红素水平为(135.78±22.36)μmol/L,高于CC组的(95.02±13.15)μmol/L,差异均有统计学意义(P<0.05);影像学检查显示,CBA组中出现胆囊形态异常的占比为72.34%(34/47),高于CC组的26.19%(11/42),而CC组中出现肝内胆管扩张、囊肿内胆泥沉积的占比分别为38.09%(16/42)和47.62%(20/42),均高于CBA组,且CC组患儿囊肿长径和囊肿宽径比CBA组增加(P<0.05);MDCT的诊断准确度、灵敏度和特异度分别为71.91%、74.47%和69.05%;MRCP为83.15%、85.11%和80.95%;两者联合为94.38%、95.74%和92.86%,联合检测优于单独检测。结论 MDCT和MRCP联合应用,可提高婴幼儿胆道梗阻类疾病的诊断准确度。

关键词: 多层螺旋 CT, 磁共振胰胆管成像, 胆总管囊肿, 囊肿型胆道闭锁

Abstract: Objective To explore the diagnostic value of Multidetector CT (MDCT) combined with Magnetic Resonance Cholangiopancreatography (MRCP) in biliary obstructive diseases in infants and toddlers.Methods A retrospective study was conducted on children with biliary obstructive diseases admitted to Children's Hospital Affiliated to Soochow University from January 2021 to January 2024. All cases were confirmed by cholangiography and postoperative pathology. Forty-seven patients with cystic biliary atresia (CBA) were assigned to the CBA group, and 42 patients with choledochal cysts (CC) were assigned to the CC group. The preoperative MDCT and MRCP findings were compared between the two groups, and the diagnostic performance was evaluated using ROC curves.Results In the CBA group, the proportion of children with clay-like stools was 21.28% (10/47), significantly higher than the 0.0% in the CC group. The total bilirubin level in the CBA group was (135.78±22.36) μmol/L, higher than the (95.02±13.15) μmol/L in the CC group, with a statistically significant difference (P<0.05). Imaging examination showed that 72.34% (34/47) of the CBA group had abnormal gallbladder shape, higher than the 26.19% (11/42) in the CC group. In contrast, in the CC group, the proportions of children with intrahepatic bile duct dilation and cystic bile sludge deposition were 38.09% (16/42) and 47.62% (20/42), both of which were higher than those in the CBA group. Additionally, the cyst length and width ratios in the CC group were greater than those in the CBA group (P<0.05). The diagnostic accuracy, sensitivity, and specificity of MDCT were 71.91%, 74.47%, and 69.05%, respectively; for MRCP, these were 83.15%, 85.11%, and 80.95%; and for the combined approach, the figures were 94.38%, 95.74%, and 92.86%, indicating that the combined test was superior to individual tests.Conclusion The combined application of MDCT and MRCP can improve the diagnostic accuracy of biliary obstruction in infants and young children.

Key words: Multidetector CT, Magnetic Resonance Cholangiopancreatography, Choledochal Cyst, Cystic Biliary Atresia

冯巍, 王兆清. 多层螺旋 CT 联合磁共振胰胆管成像检查诊断胆道梗阻性疾病的研究[J]. 肝脏, 2025, 30(3): 391-394.

FENG Wei, WANG Zhao-qing. Diagnostic value of MDCT combined with MRCP in biliary obstructive diseases in infants and toddlers[J]. Chinese Hepatolgy, 2025, 30(3): 391-394.

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