Diagnostic value of different imagines for choledocholithiasis abdominal pain
10.3760/cma.j.cn431274-20210421-00458
- VernacularTitle:不同检查方法对胆总管结石性腹痛的诊断价值
- Author:
Hanyu ZHANG
1
;
Di WU
;
Guoxing WANG
;
Miaorong XIE
;
Chunsheng LI
Author Information
1. 首都医科大学附属北京友谊医院急诊科 100050
- Keywords:
Choledocholithiasis;
Endoscopic ultrasonography;
Multislice spiral computed tomography;
Cholangiopancreatography, magnetic resonance;
B-mode ultrasound
- From:
Journal of Chinese Physician
2021;23(10):1444-1447
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate direct bilirubin /total bilirubin(D/T), B-mode ultrasound(BUS), multislice spiral computed tomography (MSCT), magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS) in the diagnosis of choledocholithiasis abdominal pain (CAP).Methods:We retrospectively analyzed the materials of patients who were diagnosed with choledocholithiasis abdominal pain by above imagines in the emergency department of Beijing Friendship Hospital during March 2016 to December 2018. The stones were taken out by endoscopic retrograde cholangiopancreatography or surgical operation as the golden standard.Results:Among 256 patients, 195 cases, 138 cases, 107 cases and 26 cases were diagnosed by EUS, MRCP, CT and BUS, respectively. The sensitivity were 0.86, 0.62, 0.45, 0.13, respectively. The specificity were 0.86, 0.81, 0.75, 0.87. The positive predictive value were 0.97, 0.96, 0.91, 0.83.The negative predictive value were 0.55, 0.19, 0.21, 0.16. The accuracy rate were 0.88, 0.64, 0.48, 0.30, respectively. The sensitivity of D/T and D/T combined with EUS in the diagnosis of CAP were 0.57 and 0.67, and the accuracy were 0.16 and 0.56, respectively.Conclusions:EUS has a high diagnostic value for CAP. MRCP is superior to CT in the value of diagnosis of CAP. BUS in imaging diagnosis of CAP value is relatively low, but D/T combined with BUS can improve the sensitivity and accuracy of diagnosis for CAP.
