安徽医科大学第一附属医院消化内科;
目的 探讨线阵内镜超声(EUS)对胆总管微结石的诊断价值。方法 选取于医院就诊并经EUS诊断为胆总管微结石和胆泥患者资料，从中筛选出住院期间行磁共振胆胰管造影(MRCP)检查和内镜逆行胰胆管造影(ERCP)诊治的患者共85例。以治疗性ERCP/内镜下十二指肠乳头括约肌切开术(EST)结果为金标准。将EUS、MRCP及诊断性ERCP结果(EUS组、MRCP组和诊断性ERCP组)分别与金标准相比较，计算3种检查方法的灵敏度、特异度、阳性预测值、阴性预测值及准确度。结果 85例患者中EUS组阳性共63例，假阳性5例；阴性共22例，假阴性1例。MRCP组阳性共49例，假阳性4例；阴性共36例，假阴性14例；诊断性ERCP组阳性共59例，假阳性10例；阴性共26例，假阴性10例。EUS组诊断胆总管微结石的灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为98.3%、80.8%、92.1%、95.4%和92.9%;MRCP组为76.3%、84.6%、91.8%、61.1%和78.8%;诊断性ERCP组为83.1%、61.5%、83.1%、61.5%和76.5%。EUS诊断胆总管微结石准确度高于MRCP组(χ~2=6.986,P<0.05)和诊断性ERCP组(χ~2=8.900,P<0.05)。EUS组、MRCP组和诊断性ERCP组曲线下面积(AUC)值分别为0.895、0.804、0.723,95%CI分别为(0.802～0.988,P<0.001)、(0.702～0.907,P<0.001)和(0.598～0.848,P=0.001)。结论 在诊断胆总管微结石方面，EUS具有较高的诊断价值，可作为治疗性ERCP术前首选检查方法。
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基本信息:
DOI：10.19405/j.cnki.issn1000-1492.2025.01.021
中图分类号:R575.7
引用信息:
[1]陈刚,张卫平,鲍峻峻等.线阵内镜超声对胆总管微结石的诊断价值[J].安徽医科大学学报,2025,60(01):147-151.DOI:10.19405/j.cnki.issn1000-1492.2025.01.021.
基金信息:
国家自然科学基金(编号：81700521); 安徽省自然科学基金(编号：2008085QH415)~~