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目的研究三维磁共振胰胆管成像(3D-MRCP)和常规核磁共振(MRI)对阻塞性黄疸鉴别诊断的价值。方法回顾性分析15例经手术确诊为胆道闭锁和66例经内科确诊为婴儿肝炎综合征患儿的3D-MRCP和常规MRI检查资料。结果 15例胆道闭锁患者中,3D-MRCP诊断13例,常规MRI诊断11例,结合诊断14例,其准确性分别为86.7%、73.3%、93.3%。66例婴儿肝炎综合征患者中,3D-MRCP诊断58例,常规MRI诊断5例,结合诊断62例,准确性分别为87.9%、7.6%、93.9%。3D-MRCP结合常规MRI检查对婴儿期阻塞性黄疸鉴别诊断的准确性、敏感性、特异性分别为93.8%、77.8%、98.4%。结论 3D-MRCP结合常规MRI检查可提高对胆道闭锁与婴儿肝炎综合征的诊断准确性。
Objective To investigate the value of three-dimensional MR cholangiopancreatography (3D-MRCP) and conventional magnetic resonance imaging (MRI) in the differential diagnosis of obstructive jaundice. Methods The data of 3D-MRCP and routine MRI in 15 cases diagnosed as biliary atresia and 66 cases of infantile hepatitis syndrome diagnosed by internal medicine were retrospectively analyzed. Results Among the 15 patients with biliary atresia, 13 cases were diagnosed by 3D-MRCP, 11 cases were diagnosed by conventional MRI and 14 cases were diagnosed by birefringence. The accuracy was 86.7%, 73.3% and 93.3% respectively. In 66 cases of infantile hepatitis syndrome, 58 cases were diagnosed by 3D-MRCP, 5 cases were diagnosed by routine MRI, and the accuracy was 87.9%, 7.6% and 93.9% respectively in 62 cases. The accuracy, sensitivity and specificity of 3D-MRCP combined with conventional MRI in the differential diagnosis of obstructive jaundice in infancy were 93.8%, 77.8% and 98.4% respectively. Conclusion 3D-MRCP combined with conventional MRI can improve the diagnostic accuracy of biliary atresia and infant hepatitis syndrome.