METHODS: We retrospectively reviewed 1079 AC patients during 2020, at 16 Tokyo Guidelines 18 (TG 18) Core Meeting institutions. Of these, the post-biliary reconstruction associated AC (PBR-AC), stent-associated AC (S-AC) and common AC (C-AC) were 228, 307, and 544, respectively. The characteristics of each AC were compared, and the TG18 diagnostic performance of each was evaluated.
RESULTS: The PBR-AC group showed significantly milder biliary stasis compared to the C-AC group. Using TG18 criteria, definitive diagnosis rate in the PBR-AC group was significantly lower than that in the C-AC group (59.6% vs. 79.6%, p < .001) because of significantly lower prevalence of TG 18 imaging findings and milder bile stasis. In the S-AC group, the bile stasis was also milder, but definitive-diagnostic rate was significantly higher (95.1%) compared to the C-AC group. The incidence of transient hepatic attenuation difference (THAD) and pneumobilia were more frequent in PBR-AC than that in C-AC. The definitive-diagnostic rate of PBR-AC (59.6%-78.1%) and total cohort (79.6%-85.3%) were significantly improved when newly adding these items to TG18 diagnostic imaging findings.
CONCLUSIONS: The diagnostic rate of PBR-AC using TG18 is low, but adding THAD and pneumobilia to TG imaging criteria may improve TG diagnostic performance.
方法:我们回顾性回顾了2020年在16个东京指南18(TG18)核心会议机构中的1079例AC患者。其中,胆道重建后相关AC(PBR-AC),支架相关AC(S-AC)和普通AC(C-AC)分别为228、307和544。比较了每种AC的特性,并评估了各自的TG18诊断性能。
结果:与C-AC组相比,PBR-AC组表现出明显温和的胆汁淤滞。使用TG18标准,PBR-AC组确诊率明显低于C-AC组(59.6%vs.79.6%,p<.001),因为TG18影像学发现的患病率显着降低,胆汁淤滞较轻。在S-AC组中,胆汁淤积也较温和,但明确诊断率明显高于C-AC组(95.1%).PBR-AC与C-AC相比,短暂的肝衰减差异(THAD)和血栓形成的发生率更高。当将这些项目新添加到TG18诊断影像学发现中时,PBR-AC的最终诊断率(59.6%-78.1%)和总队列(79.6%-85.3%)显着提高。
结论:使用TG18对PBR-AC的诊断率较低,但在TG成像标准中加入THAD和pneumobilia可能会提高TG诊断性能.