The Application Value Of Virtual Endoscopy In Intrahepatic Biliary Calculi

The abstract includes following parts:Research Background and Purpose: It is a common disease that hepatic intrahepatic biliary calculi with diverse clinical manifestations,including upper abdominal pain,jaundice,fever,nausea,vomiting,etc.Traditional imaging techniques such as ultrasound,CT,and MRCP can be used to diagnose hepatic intrahepatic duct stones,but these methods still have certain limitations,such as the inability to determine the specific location,size,and shape of the stones,which makes it difficult to provide accurate localization and guidance for surgery.With the continuous development of virtual endoscopy technology,its application in the diagnosis of hepatic intrahepatic duct stones has gradually received attention.Virtual endoscopy technology can reconstruct CT or MRI imaging results in three dimensions,enabling a stereoscopic observation of hepatic intrahepatic duct stones,thus providing a highprecision diagnostic method.Virtual endoscopy technology can not only display specific information such as the location,size,and shape of the stones,but also observe the narrowing and dilation of the hepatic intrahepatic duct,providing more accurate localization and guidance for surgery.This article aims to review the application status of virtual endoscopy technology in the diagnosis of hepatic intrahepatic duct stones and discuss its advantages and disadvantages.The focus will be on exploring the diagnostic accuracy and clinical application prospects of virtual endoscopy technology in hepatic intrahepatic duct stones and comparing and analyzing it with traditional imaging techniques.It is hoped that through this discussion,more accurate and reliable diagnostic methods can be provided for clinical doctors,and better reference basis can be provided for the treatment and management of hepatic intrahepatic duct stones.Research Method and Process: Data of 40 patients from the Department of Hepatobiliary Surgery,The Second Affiliated Hospital of Guangzhou Medical University,who underwent contrast-enhanced imaging and 3D reconstruction from December 2020 to June 2021 were collected.Among them,there were 28 cases of intrahepatic bile duct stones,7 cases of tumors,1 case of bile leakage,and 1 case of bile duct stenosis.Two cases with poor patient compliance resulted in poor 3D imaging,and one case with bile duct stenosis could not undergo PTCS and was excluded.The original images of 3D-MRCP and 3D-PTC were imported into Philips Interventional Workstations R1.4.5.1007 software for 3D post-processing,reconstruction,and virtual endoscopy.The sensitivity and specificity of VE diagnosis were calculated based on the surgical results as the "gold standard".Statistical analysis was performed using SPSSPRO.(Version 1.0.11).The categorical variables were expressed as frequencies.Kappa consistency test was used to compare the diagnostic results of VE and surgery.Research Results: Among the patients who underwent virtual cholangioscopy,28 cases of intrahepatic bile duct calculi and 7 cases of non-calculus(tumor)were selected.When evaluating the sensitivity and specificity of cholangioscopy diagnosis,only a diagnosis from the perspective of imaging was made.The cholangioscopy diagnosis results were as follows: 24 cases of intrahepatic bile duct calculi,4suspected cases of calculi,1 missed diagnosis of bile duct calculi,and 6 non-calculus(tumor)cases.Overall,the diagnosis rate of large calculi by cholangioscopy was relatively high,with a sensitivity of 86% and a specificity of 86%.Kappa consistency testing was performed to compare the cholangioscopy diagnosis results with the surgical results,and the value of the Kappa coefficient was 0.286,indicating a moderate degree of correlation.Research Conclusion: Virtual endoscopy technology has also been widely used in the diagnosis of biliary stones.By using computer reconstruction of a threedimensional model of the biliary system,doctors can observe the position,size,number,and shape of stones inside the ducts very clearly,enabling more accurate diagnosis of biliary stones.However,biliary virtual endoscopy still has certain limitations,such as low spatial resolution,inability to truly display changes in lesion color,and inability to display the fine structure of the mucosa,which cannot completely replace invasive fiber endoscopy.