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| Manifestations and diagnostic value of MRCP in patients with cholecystolithiasis complicated with cholecystitis#br# |
| CAI Wenjing CHENG Nansheng JIN-ZHANG Long |
| Imaging Center, Anqing First People’s Hospital of Anhui Province, Anhui Province, Anqing 246003, China |
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Abstract Objective To explore manifestations and diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in patients with cholecystolithiasis complicated with cholecystitis. Methods The clinical data of 80 patients who underwent laparoscopic cholecystectomy in Anqing First People’s Hospital of Anhui Province from July 2018 to April 2021 were retrospectively analyzed. All subjects underwent upper abdominal MRCP examination and color ultrasound examination before surgery. MRCP and color ultrasound manifestations of patients with cholecystolithiasis complicated with cholecystitis were observed, and the diagnostic efficacy of MRCP and color ultrasound in cholecystolithiasis complicated with cholecystitis was compared. The receiver operator characteristic curve was drawn and the area under the curves was calculated. Results A total of 37 cases were diagnosed as cholecystolithiasis complicated with cholecystitis, and the remaining 43 cases were chronic cholecystitis. Among MRCP examination results, 33 patients with cholecystolithiasis complicated with cholecystitis were clearly diagnosed in 37 patients, the gallbladder was obviously dilated, and the common bile duct, left and right bile ducts, and pancreatic duct were clearly displayed, different numbers of stones were seen in the duct, with round, oval, strip, and irregular shapes. A total of 24 cases were diagnosed clearly by color ultrasound, the gallbladder was obviously dilated and the ducts and stones were clearly displayed. The sensitivity, specificity, and accuracy of MRCP in the diagnosis of cholecystolithiasis complicated with cholecystitis were 89.19%, 97.67%, and 93.75%, respectively. The area under curve of MRCP was significantly higher than that of color ultrasound, and the difference was highly statistically significant (P < 0.01). Conclusion The accuracy of MRCP in the diagnosis of cholecystolithiasis complicated with cholecystitis is higher than that of color ultrasound. Preoperative MRCP examination is of great significance for patients with cholecystitis suspected of having gallstones, which is worthy of active promotion in clinical practice.
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[1] 罗登，赖习华，刘首记.腹腔镜胆囊切除术治疗胆囊结石伴慢性胆囊炎患者治疗效果分析[J].实用肝脏病杂志，2021，24（2）：276-279.
[2] Nagata S，Goshima S，Noda Y，et al. Magnetic resonance cholangiopancreatography using optimized integrated combination with parallel imaging and compressed sensing technique [J]. Abdom Radiol（NY），2019，44（5）：1766-1772.
[3] 黄鹏，魏屹，李明武.腹腔镜胆囊切除术早期治疗胆囊结石并发的急性胆源性胰腺炎的临床效果[J].中国医药导报，2020，17（23）：111-114.
[4] 李海东，徐安安，王波，等.经脐单孔腹腔镜胆囊切除术治疗慢性胆囊炎合并胆囊结石[J].中华肝胆外科杂志，2019，25（10）：733-736.
[5] 康洁，崔雷雷，路萌，等.MSCT后处理技术、MRCP与B超对胆系结石的诊断价值[J].河北医药，2020，42（1）：102-105.
[6] 祝佩瑶，杨军，杨勇，等.彩超初诊为胆囊结石患者行磁共振胰胆管造影的必要性及指征分析[J].临床肝胆病杂志，2019，35（6）：1293-1298.
[7] 洪杰，蔡琦，崔巍.3.0T MRCP联合腹部彩超在可疑胆囊结石诊断中的应用价值[J].中国医药导报，2021，18（19）：159-162.
[8] 许逸超，徐正道，张家会，等.三维屏气梯度-自旋回波序列在MR胰胆管成像中的应用[J].中华放射学杂志，2021， 55（1）：64-69.
[9] 中华消化杂志编辑委员会，中华医学会消化病学分会肝胆疾病协作组.中国慢性胆囊炎、胆囊结石内科诊疗共识意见（2018年）[J].临床肝胆病杂志，2019，35（6）：1231-1236.
[10] 朱西琪，吕健，覃小燕，等.胆囊结石合并胆囊炎患者腹腔镜胆囊切除术前采用多层螺旋CT检查的临床应用价值[J].中国全科医学，2019，22（S1）：157-160.
[11] 朱朋，刘罗海，张瑾.不同Calot三角解剖入路腹腔镜胆囊切除术治疗胆囊结石合并慢性胆囊炎的临床疗效[J].临床和实验医学杂志，2021，20（16）：1730-1733.
[12] Ishaque I，Ilyas A，Khan O，et al. Role of magnetic resonance cholangiopancreatography（MRCP）in learning anatomical variations in pancreatic duct [J]. J Pak Med Assoc，2020，70（3）：472-476.
[13] 章俊芹，裴仁明，马娜.MRCP对胆囊结石的诊断及应用价值分析[J].湖南师范大学学报：医学版，2020，17（2）：96-98.
[14] Thacoor A，Pike TW，Pathak S，et al. The role of intraoperative cholangiography in patients undergoing laparoscopic cholecystectomy for acute gallstone pancreatitis：is magnetic resonance cholangiopancreatography needed? [J]. Ann R Coll Surg Engl，2019，101（6）：428-431.
[15] 刘威，沈根海，高泉根，等.磁共振胰胆管成像对胆总管结石的假阴性诊断[J].肝胆胰外科杂志，2019，31（3）：163-165.
[16] Donoghue S，Jones RM，Bush A，et al. Cost effectiveness of intraoperative laparoscopic ultrasound for suspected choledocholithiasis; outcomes from a specialist benign upper gastrointestinal unit [J]. Ann R Coll Surg Engl，2020，102（8）：598-600.
[17] 闫昆，丁忠祥，陈国平，等.磁共振成像对胆囊结石伴胆囊壁弥漫性炎性增厚患者治疗选择的价值[J].中华肝胆外科杂志，2019，25（12）：899-904.
[18] Saito H，Iwagoi Y，Noda K，et al. Dual-layer spectral detector computed tomography versus magnetic resonance cholangiopancreatography for biliary stones [J]. Eur J Gastroenterol Hepatol，2021，33（1）：32-39.
[19] 徐畅，程庆保，吴小兵，等.磁共振胆胰管造影数字量化诊断法在鉴别Ic型胆总管囊肿中的应用[J].中华肝胆外科杂志，2019，25（12）：905-909.
[20] 丁金立，王志平，卓芝政，等.2D-SSh-MRCP序列与基于压缩感知技术的CS-3D-MRCP序列在胰胆管成像中的对比研究[J].北京生物医学工程，2020，39（3）：290-295.
[21] 庞艳波.胰胆管水成像及多层旋螺CT在胆管疾病中的诊断价值比较[J].中国当代医药，2020，27（6）：66-68，72.
[22] 董红焕，康立清，李佳玥，等.低张饮水MRCP结合不压脂T2Wl及LAVA动态增强对十二指肠乳头腺癌的诊断价值[J].中外医学研究，2020，18（29）：84-86.
[23] 刘新亮，李洪义，包权，等.胆囊管变异不同类型与胆囊结石相关性的MRCP研究[J].中国CT和MRI杂志，2019，17（10）：75-78.
[24] 徐降兴，肖义容，杨小红，等.MRCP诊治胆囊结石合并正常范围直径胆总管结石中的应用价值及有效性分析[J].临床外科杂志，2019，27（3）：250-252.
[25] Lee SL，Kim HK，Choi HH，et al. Diagnostic value of magnetic resonance cholangiopancreatography to detect bile duct stones in acute biliary pancreatitis [J]. Pancreatology，2018，18（1）：22-28.
[26] 孙振福，荆涛，万泰虎.MRCP联合T2WI冠位薄扫对肝外胆管结石诊断价值[J].中国实验诊断学，2020，24（8）：1272-1274.
[27] 李鸿晔，韦亚蓉，李会会，等.胆总管远端狭窄超声内镜特征分析[J].临床肝胆病杂志，2021，37（11）：2632-2635.
[28] López Alza LC，Ramírez Villamila AG，Moreno Gómez LA，et al. Magnetic resonance cholangiopancreatography identification of pancreaticobiliary maljunction in the colombian pediatric population [J]. Cir Pediatr，2020，33（4）：177-182.
[29] 尼加提·塔西甫拉提，地力木热提·艾买提，张新峰，等.胆囊结石合并胆总管结石的相关危险因素分析[J].中华普通外科杂志，2020，35（8）：633-636. |
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