ROC曲线图分析内镜逆行胰胆管造影、磁共振胰胆管显影和CT对胆胰疾病的诊断价值
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)(2013)
Abstract
目的评价内镜逆行胰胆管造影(ERCP)和磁共振胰胆管造影(MRCP)和CT单独或联合应用对胆胰疾病的诊断价值及三者的一致性和互补性。方法回顾性分析424例行ERCP、CT和MRCP检查患者的临床资料,采用同步盲法和ROC曲线比较ERCP、CT和MRCP对胆胰疾病诊断的敏感性、特异性、准确性、阳性预测值和阴性预测值;分析三者的互补性和一致性。结果分析结果显示ERCP、MRCP和CT的Az值(Az值为下面积)分别为0.9281±0.0455,0.8833±0.0400和0.8687±0.0168。对胆胰疾病的诊断,ERCP诊断正确率为93.86%(398/424),显著高于MRCP的85.06%(131/154)和CT的79.45%(116/146)(χ2=15.64,P<0.05)。ERCP、MRCP和CT三种方法同时检查,其诊断准确性达96.23%(102/106),明显高于ERCP+MRCP(84.96%,96/113,χ2=8.02,P<0.05)或ERCP+CT(86.99%,127/146,χ2=6.32,P<0.05)两种方法同时检查的诊断准确性。7例胰腺癌和6例慢性胰腺炎ERCP、MRCP和CT诊断的一致性分别是4和3例,三者结合均明确诊断。结论 ERCP对胆胰疾病诊断的准确性明显高于MRCP和CT,三者结合可提高胆胰疾病的诊断率,特别对胰腺癌和慢性胰腺炎,ERCP、MRCP和CT具有一定的一致性和很好的互补性。
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Key words
Cholangiopancreatography,Pancreatic diseases,ROC curve,X-ray computed,Tomography,Gallbladder diseases,magnetic resonance,endoscopic retrograde
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