MRCP与ERCP对梗阻性黄疸疾病诊断的比较分析

目的：比较内镜逆行胰胆管造影（ERCP）和磁共振胰胆管造影（MRCP）对胆管梗阻性疾病的诊断价值。方法：通过ERCP和MRCP影像资料对132例胆管梗阻进行对比分析。结果：诊断结果表明,两者一致的117例（88.6%）,不一致13例（9.8%）,总符合率MR-CP为88.6%,ERCP为98.4%。患者行MRCP后无并发症,但行ERCP检查后有9例出现并发症,发生率为6.8%,但无死亡病例。结论：MRCP在胆管梗阻性疾病诊断方面具有操作简便、安全、无创伤性,经济实惠等优点,诊断胆总管扩张的敏感性及准确性较高,但对胆总管较小结石（〈3 mm）的诊断不如ERCP准确,而且不能行取石治疗。因此MRCP在对胆管梗阻性疾病的诊断中应作为首选方法,但不能取代ERCP,两者需结合。

Comparison between ERCP and MRCP in diagnosis of obstructive jaundice

Objective ：To compare the diagnostic values of endoscopic retrograde cholangiopancreatography （ERCP） and MR cholangiopancreatography（MRCP） for the malignant obstruction diseases of biliary tract. Methods：The parallel analysis for the ERCP and MRCP data of 132 patients with biliary obstruction confirmed by surgery and/or ERCP was retrospectively carried out.Results：All the 132 patients with the same diagnosis based on MRCP and ERCP was117 patients （88.6%）. The different diagnosis was in 13 patients （9.8%）. Conclusion： MRCP has a noninvasive diagnostic value of producing high quality imagines of bile duct and pancreatic tract. MRCP has a high sensitivity and specificity in the evaluation of the bile duct and pancreatic tract. The efficacy of MRCP is sufficient to justify its use in the diagnosis of bile duct and pancreatic tract diseases, but not to replace ERCP perfectly.