目的 分析磁共振胰胆管成像 (MRCP)诊断胆总管结石的临床价值及患 者心理状态的影响因素。方法 抽取本院 2018年3月-2019年1月55例胆总管结石患 者，均接受二维、三维MRCP(2DMRCP、 3DMRCP)及T2加权成像脂肪抑制序列 (FIESTA)检查，并经术中取石或胆道镜 探查结果证实。检查后以症状自评量表 (SCL-90)评估心理状态，分析患者的一般 资料、MRCP检查情况与SCL-90总分的关 系，并进行logistic回归分析。结果 3种 扫描方式检查结石显示率均≥80%，联合 诊断率为94.55%，仅3例因结石直径＜5mm 未被检出。结石形态可呈现圆形、椭圆 形、条状和不规则形，2DMRCP、3DMRCP、 FIESTA图像上胆总管结石均呈低或稍低信 号充盈缺损影。本组55例患者SCL-90评估 显示抑郁、焦虑、恐怖、偏执4个维度评 分均＞2分，其余各维度评分基本正常， SCL-90总分(26.23±5.74)分。单因素和 多因素分析显示年龄、检查前未进行心理 干预、MRCP时间长、并发症是影响MRCP检 查患者心理状态的危险因素(P＜0.05)。 结论 2DMRCP、3DMRCP结合FIESTA检查对 胆总管结石的诊断价值高，但MRCP检查可 影响患者的心理状态，应从心理疏导、缩 短检查时间、防治并发症等方面进行干 预。

Objective To analyze the clinical value of magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of choledocholithiasis and the influencing factors of psychological status. Methods A total of 55 patients with choledocholithiasis in the hospital from March 2018 to January 2019 were enrolled. All patients underwent two-dimensional and three-dimensional MRCP (2DMRCP, 3DMRCP) and T2-weighted imaging fat suppression sequence (FIESTA), and they were confirmed by the results of intraoperative lithotomy and cholangioscopic exploration. After examination, the psychological status was evaluated by the Symptom Checklist 90 (SCL90). The general data and the relationship between the MRCP examination and the total score of SCL-90 were analyzed. Logistic regression analysis was performed. Results The display rates of the three scan methods for examining the stones equaled to or were greater than 80%. The combined diagnosis rate was 94.55%. There were only 3 cases not detected due to stone diameter less than 5mm. The shape of the stones was round, elliptical, strip and irregular. In the images of 2DMRCP, 3DMRCP and FIESTA , choledocholithiasis showed low or slightly low signal and filling defect shadow. The SCL-90 evaluation for the 55 patients showed that the scores in depression, anxiety, horror and paranoia were greater than 2 points. The scores of the other dimensions were basically normal. The total score of SCL-90 was (26.23±5.74) points. Univariate and multivariate analysis showed that age, no psychological intervention before examination, long duration of MRCP and complications were risk factors affecting the psychological status of patients undergoing MRCP (P<0.05). Conclusion The diagnostic value of 2DMRCP, 3DMRCP combined with FIESTA examination is high for choledocholithiasis. But MRCP examination can affect psychological status of patients. Intervention should be conducted from the aspects such psychological counseling, shortening examination time and controlling complications.