磁共振在肛周脓肿诊断中的临床应用

目的:开展腔内水囊技术引导下MRI检查,探索MRI技术在肛周脓肿诊断治疗中的运用意义。方法:22例临床诊断为肛周脓肿的患者术前进行磁共振相控阵列线圈检查。以手术结果为标准,比较术前局部检查、放射科医师及专科医师MRI读片结果。结果:在22例(高位16例,低位6例)肛周脓肿患者中,对于涉及间隙的判断,术前指诊准确率为50%,放射医师读片准确率90.9%,专科医师读片准确率95.4%,后两者与术前指诊结果比较差异均有统计学意义(P<0.05);对于内口,术前指诊检出率为86.3%,放射科读片检出率为27.2%,专科读片检出率为31.8%,后两者与术前指诊结果比较差异均有统计学意义(P<0.05)。在高位脓肿组中术前指诊、放射科读片、专科读片内口检出率分别为87.5%、37.5%、43.7%,与术前指诊结果比较差异均有统计学意义(P<0.05)。结论:对脓肿涉及间隙的判断,MRI提供了很好的指导价值,但对于内口的正确判断术前肛门直肠指诊更有积极意义;尤其对高位肛周脓肿而言,MRI检查在脓肿内口的提示、验证方面更能发挥重要作用。

The clinical application of MR in the diagnosis of perianal abscesses

Objective:To explore the clinical value of MR which under the guidance of the modified three channel tube in the diagnosis of perianal abscesses.Methods:The preoperative digital examination and MRI with the phased array coil were implemented for 22 patients who were clinically suspected with perianal abscesses.The final diagnosis were based on surgical findings.Outcomes of MRI digital examination were compared with surgical results.Results:In the judgment of involved gap,the accuracy rate of digital examination was 50%,the rate of the radiologists’reading was 90.9%,and the accuracy rate of Anorectal physician’s reading was 95.4%.The diagnosis rates of the internal opening with preoperative examination was 86.3%,which with MRI by radiologists’reading was 27.2% and which with MRI by anorectal physician’s reading was 31.8%.The differences in detection of internal opening and involved gap between MRI and preoperative examination were significant(P<0.05).Conclusion:MR imaging is critical for the involved gap ofperianal,and the digital paly more important role in the detection of internal opening than MRI.Especially for high perianal abscess,MRI can demonstrate more advantages.