蒋丽萍,刘娜香,陈云超,黄道中,李开艳,张青萍.高频超声与MRI鉴别诊断胆管闭锁[J].中国医学影像技术,2011,27(6):1201~1204
高频超声与MRI鉴别诊断胆管闭锁
High-frequency ultrasonography and MRI in differential diagnosis of biliary atresia
投稿时间:2010-11-30  修订日期:2011-01-18
DOI:
中文关键词:  超声检查  磁共振成像  胆管闭锁  鉴别诊断
英文关键词:Ultrasonography  Magnetic resonance imaging  Biliary atresia  Differential diagnosis
基金项目:2008年华中科技大学同济医学院附属同济医院临床新技术新业务项目(2008057)。
作者单位E-mail
蒋丽萍 华中科技大学同济医学院附属同济医院超声科,湖北 武汉 430030  
刘娜香 华中科技大学同济医学院附属同济医院超声科,湖北 武汉 430030  
陈云超 华中科技大学同济医学院附属同济医院超声科,湖北 武汉 430030 chen-yunchao@yahoo.com.cn 
黄道中 华中科技大学同济医学院附属同济医院超声科,湖北 武汉 430030  
李开艳 华中科技大学同济医学院附属同济医院超声科,湖北 武汉 430030  
张青萍 华中科技大学同济医学院附属同济医院超声科,湖北 武汉 430030  
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中文摘要:
       目的 探讨高频超声与MRI对胆管闭锁及非胆管闭锁性黄疸的鉴别诊断价值。方法 对47例黄疸患儿进行高频超声检查,观察TC征、肝右动脉和胆囊等;对其中23例患儿行MR检查,观察胆总管、肝总管和胆囊。以肝穿刺组织学检查、术后病理检查结果或临床痊愈为金标准,对比两种方法诊断小儿黄疸的敏感度、特异度及准确率。结果 47例患儿中,胆管闭锁19例、非胆管闭锁28例。高频超声观察指标中,TC征阳性、肝右动脉增宽和异常胆囊对诊断胆管闭锁的诊断价值较高,以其中两项阳性诊断胆管闭锁的敏感度、特异度及准确率分别为94.47%(18/19)、92.86%(26/28)和93.62%(44/47)。MRI观察指标中,以胆总管、肝总管未显示或不连续(伴或不伴胆囊未显示)诊断胆管闭锁的敏感度、特异度及准确率分别为44.44%(8/18)、80.00%(4/5)和52.17%(12/23)。结论 高频超声对鉴别胆管闭锁及非胆管闭锁性黄疸有较高的准确率,可作为首选检查方法。
英文摘要:
      Objective To observe value of MRI and high-frequency ultrasonography (HUS) in differential diagnosis of biliary atresia (BA) from non-biliary atresia (non-BA). Methods Totally 47 children with cholestatic jaundice underwent abdominal HUS, while the TC sign, right hepatic artery and gallbladder were observed and measured. Twenty-three of them underwent MRI, the common bile duct, common hepatic duct and gallbladder were observed. Taking findings of the liver puncture biopsy, pathological reports after operation and clinical recovery as gold standards, the sensitivity, specificity and accuracy were compared between HUS and MRI. Results There were 19 BA and 28 non-BA in 47 children with cholestatic jaundice. In HUS, the positive TC sign, hypertrophy right hepatic artery and abnormal gallbladder were three important signs for diagnosis of BA. The diagnostic sensitivity, specificity and accuracy was 94.47% (18/19), 92.86% (26/28)and 93.62% (44/47) respectively when two of the three signs were presented by HUS. However, the diagnostic sensitivity, specificity and accuracy of MRI was 44.44% (8/18), 80.00% (4/5) and 52.17% (12/23). Conclusion HUS has high diagnostic accuracy, and can be considered as the first choice to differentiate BA from non-BA.
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