磁共振胰胆管成像技术与多排螺旋CT在恶性胆道梗阻诊断中的比较

肝脏 ›› 2025, Vol. 30 ›› Issue (9): 1258-1262.

磁共振胰胆管成像技术与多排螺旋CT在恶性胆道梗阻诊断中的比较

吴士臣, 江凯, 张翟文, 史传奇, 张兆东

215101 苏州苏州市中西医结合医院影像科(吴士臣,张兆东);226001 南通南通市第六人民医院影像科(江凯);200433 上海长海医院放射诊断科(张翟文);215002 苏州苏州市立医院本部影像科(史传奇)

收稿日期:2024-09-07 出版日期:2025-09-30 发布日期:2025-11-05
通讯作者: 张兆东,Email:1320765480@qq.com
基金资助:
江苏省自然科学基金资助项目(BK20211131)

A comparative study of MRCP and multi row spiral CT in the diagnosis of malignant biliary obstruction

WU Shi-chen¹, JIANG Kai², ZHANG Zhai-wen³, SHI Chuan-qi⁴, ZHANG Zhao-dong¹

1. Department of Imaging,Suzhou Integrated Traditional Chinese and Western Medicine Hospital, Suzhou 215101,China;
2. Department of Imaging,Nantong Sixth People's Hospital,Nantong 226001,China;
3. Department of Radiological Diagnosis,Shanghai Changhai Hospital,Shanghai 200433,China;
4. Department of Imaging,Suzhou Municipal Hospital Headquarters, Suzhou 215002, China

Received:2024-09-07 Online:2025-09-30 Published:2025-11-05
Contact: ZHANG Zhao-dong,Email:1320765480@qq.com

摘要/Abstract

摘要： 目的探讨磁共振胰胆管成像(MRCP)技术联合多排螺旋CT在恶性胆道梗阻诊断中的效果与价值。方法选择2019年3月至2023年9月在苏州市中西医结合医院就诊的82例恶性胆道梗阻患者为研究对象,所有患者均进行MRCP和多排螺旋CT检查。比较MRCP与多排螺旋CT在胆管显示能力上的差异,并比较患者的MRCP和多排螺旋CT影像学特征,包括胆道狭窄、肿瘤阻塞以及周围肝组织受累等情况,分析两种方法在定位诊断结果上的差别;采用受试者工作特征(ROC)曲线分析MRCP、多排螺旋CT及两者联合在恶性胆道梗阻中的诊断价值及准确性。结果胆管显示能力方面,MRCP的平均胆管显示能力为4.23°,多排螺旋CT的平均胆管显示能力为4.01°;在恶性胆道梗阻的影像学图像中,两种技术均显示为胆管壁不规则增厚并伴有逆行性肝内胆管扩张;血管受侵犯主要表现为狭窄或闭塞;淋巴结转移常表现为短径增大或呈圆形或环形强化;器官受侵犯则表现为病灶与其分界不清或可见低密度坏死灶。两种技术在胆道狭窄和肿瘤阻塞方面显示出差异,但两者与临床诊断结果的对比都表现出较高的一致性。ROC曲线分析显示,MRCP、多排螺旋CT及两者联合诊断恶性胆道梗阻的AUC分别为0.889、0.870、0.948;对应的灵敏度为87.80%、93.80%、97.78%。结论磁共振胰胆管成像技术(MRCP)联合多排螺旋CT在恶性胆道梗阻诊断中具有显著的诊断价值,可明显提高其诊断准确性,推荐在临床中广泛应用。

关键词: 磁共振胰胆管成像技术, 多排螺旋CT, 恶性胆道梗阻

Abstract: Objective To explore the effectiveness and value of magnetic resonance cholangiopancreatography (MRCP) combined with multi row spiral CT in the diagnosis of malignant biliary obstruction. Methods 82 patients with malignant biliary obstruction who received treatment at Suzhou Integrated Traditional Chinese and Western Medicine Hospital from March 2019 to September 2023 were selected. All of the patients had underwent MRCP and multi row spiral CT examinations. The differences in bile duct display ability between MRCP and multi row spiral CT, compare the imaging features of patients with MRCP and multi row spiral CT, including biliary stricture, tumor obstruction, and surrounding liver tissue involvement, and analyze the differences in localization diagnosis results between the two methods were compared; Receiver operating characteristic curve (ROC) was performed to analyze the value and accuracy of MRCP, multi slice spiral CT, and their combination in the diagnosis of malignant biliary obstruction. Results The average bile duct display ability of MRCP was 4.23°, which was 4.01° of multi row spiral CT; In the imaging images of malignant biliary obstruction, both groups showed irregular thickening of the bile duct wall accompanied by retrograde intrahepatic bile duct dilation; The main manifestation of vascular invasion was stenosis or occlusion; Lymph node metastasis often manifested as an increase in short diameter or enhancement in a circular or circular shape; The manifestation of organ invasion was unclear boundary and low-density necrotic lesion. Two methods showed differences in biliary stenosis and tumor obstruction, but both had high consistency with clinical diagnostic results; ROC analysis showed that, MRCP、 The AUC for the diagnosis of malignant biliary obstruction using multi row spiral CT and their combination were 0.889, 0.870, and 0.948, respectively; The corresponding sensitivities were 87.80%, 93.80%, and 97.78%. Conclusion Magnetic resonance cholangiopancreatography (MRCP) combined with multi row spiral CT had significant diagnostic value in the diagnosis of malignant biliary obstruction, which could significantly improve its diagnostic accuracy. It is worthy to be widely used in clinical practice.

Key words: Magnetic resonance cholangiopancreatography technology, Multi row spiral CT, Malignant biliary obstruction

吴士臣, 江凯, 张翟文, 史传奇, 张兆东. 磁共振胰胆管成像技术与多排螺旋CT在恶性胆道梗阻诊断中的比较[J]. 肝脏, 2025, 30(9): 1258-1262.

WU Shi-chen, JIANG Kai, ZHANG Zhai-wen, SHI Chuan-qi, ZHANG Zhao-dong. A comparative study of MRCP and multi row spiral CT in the diagnosis of malignant biliary obstruction[J]. Chinese Hepatolgy, 2025, 30(9): 1258-1262.

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