胆管残余结石的影像学诊断进展与策略

摘要

胆管残余结石是胆道疾病治疗后的常见并发症,多样化的临床表现可能导致急性胆管炎与胰腺炎,影响患者预后,并增加医疗负担。因此,建立快速准确的诊断流程至关重要。本文重点论述了无创性检查（如超声、CT、磁共振胰胆管造影等）与有创性检查（如术中胆道造影、内镜逆行胰胆管造影、超声内镜等）的原理、敏感性、特异性及优缺点。超声内镜在微小结石检测中表现出高敏感性,是磁共振胰胆管造影的重要补充;内镜逆行胰胆管造影兼具诊断与治疗功能,成为金标准。理想的诊断策略应根据患者症状、危险因素及医疗资源,遵循个体化、分层路径。未来,人工智能辅助诊断等新技术有望提升诊断准确性,改善患者预后。

关键词

胆管残余结石 / 诊断 / 胰胆管造影术 / 磁共振 / 超声内镜 / 胰胆管造影术 / 内窥镜逆行 / 综述

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