Mirizzi综合征15例的术前诊断分析

摘要

Objectives To evaluate the methodology of preope rativediagnosis for Mirizzi syndrome. Methods Fifteen cases of Mirizzi syndrome were retrospectively investigated . The data of semeiology and imaging including B-type ultrasound, endoscopic re trograde cholangiopancreatography (ERCP) and MR cholangiopancreatography (MRCP) were compared with each other and analyzed. Results Preoperative data were consistent with and suggestive of Miriz zi syndrome in 93% (14/15) of cases, and in 67% (10/15) of cases, respectively. Conclusions Preoperative B-type u ltrasound is the primary examination. ERCP and MRCP further elevate preoperative definite diagnosis. In patients with preoperative tentative diagnosis of Mirizz i syndrome, jaundice lasting for more than 7 week is suggestive of cholecystocho ledochal fistula.%目的 探讨Mirizzi综合征术前诊断的方法。方法 回顾性分析研究15例Mirizzi综合征患者的临床症状及术前B超、内镜逆行胰胆管造影（ERCP）、磁共振胰胆管显影（MRCP）等影像学资料。 结果 术前93%（14/15）的病例不能除外此征，67%（10/15）于诊断时考虑此征，47%（7/15）高度怀疑此征。结论 B超是术前诊断的首选检查方法，ERCP广泛而熟练的应用是提高术前诊断率的必要条件，MRCP能够应用并提高其术前诊断率。在考虑Mirizzi综合征诊断的前提下，术前黄疸持续时间超过7周者可能存在瘘，超过8周者存在瘘的可能性极大。