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目的应用ROC曲线法探讨MDCT阴性法胰胆管成像在临床疑诊胆道梗阻中的诊断价值。方法30例患者行MDCT动、静脉双期增强扫描,利用静脉期原始数据进行多平面重建、容积再现以及最低密度成像重建。由2位资深医师双盲法读片,使用SPSS11.5进行ROC曲线分析,阅片者间差异性评价采用Kappa一致性检验。结果2位阅片医师对MDCT阴性法胰胆管成像检查的ROC曲线下的面积AZ值分别为00.968、0.962,均>0.9,表明其诊断价值较高。2位阅片医师间诊断结果的一致性检验相当满意(K=0.865)。结论MDCT阴性法胰胆管成像检查可以作为临床疑诊胆道梗阻性疾病的常规检查方法。
Objective To evaluate the diagnostic value of MDCT-negative cholangiopancreatography in clinically suspected biliary obstruction by ROC curve method. Methods Thirty patients underwent MDCT dynamic and venous double-phase contrast-enhanced MRI. The original data of venous phase were used for multiplanar reconstruction, volumetric reconstruction and reconstruction of the lowest density imaging. Two senior physicians were read by double-blind method, analyzed by ROC curve using SPSS11.5, and the difference between readers was evaluated by Kappa consistency test. Results The radiographic area under the ROC curve of MDCT-negative pancreaticobiliary imaging was 00.968,0.962, all of which were higher than 0.9, indicating that the two diagnosticians had higher diagnostic value. The concordance test between 2 physicians was quite satisfactory (K = 0.865). Conclusion MDCT negative cholangiopancreatography can be used as a routine diagnostic method for clinical suspected biliary obstructive diseases.