3.0 T磁共振多序列成像在肛瘘诊断分型中的应用效果分析

目的 探究3.0 T磁共振多序列成像在肛瘘诊断和临床分型判断中的应用价值.方法 回顾性分析56例肛瘘患者临床及影像学资料,所有患者均行3.0 T磁共振多序列成像检查,检查序列包括T1加权成像(T1WI)、T2加权成像(T2WI)、T2WI抑脂序列、扩散加权成像(DWI)序列和增强扫描,分析肛瘘不同扫描序列影像学特征,比...

Effect analysis of applying 3.0 T multi-sequence MRI in the diagnosis and classification of anal fistula

Objective To investigate the application value of 3.0 T multi-sequence magnetic resonance imaging(MRI)in the diagnosis and clinical classification of anal fistula.Methods The clinical and imaging data of 56 patients with anal fistula was retrospectively analyzed.All patients were subjected to 3.0 T MRI examination.The examination sequence comprised T1 weighted imaging(T1WI),T2 weighted imaging(T2WI),T2WI lipid suppression sequence,diffusion weighted imaging(DWI)sequence and enhanced scan.The imaging characteristics of different scanning sequences of anal fistula were analyzed.The accuracy of different sequences in displaying internal opening and fistula of the anal fistula was compared.Anal fistulas were divided into intersphincteric type,transsphincteric type,suprasphincteric type,external sphincter type and complex type based on the position and course of anal fistula combined with Praks classification and clinical experience.Results The fistula showed a stripe-like shadow low signal on T1WI,and a strip-like or tubular shape high signal on T2WI sequence,T2WI lipid suppression sequence and DWI sequence.On T1WI enhanced image,the fistula showed an improved signal of clear tubular shape with most of the inner mouth representing as enhanced round points.12 cases were of intersphincteric type,14 cases were of transsphincteric type,7 cases were of suprasphincteric type,6 cases were of external sphincter type,and 17 cases were of complex type.Pathological examination of 56 patients confirmed that there were 43 internal orifices and 62 fistulas,wherein the internal orifices located in the 3-9 o’clock direction of the lithotomy.T1WI sequence showed 36 internal openings(83.72%)and 53 fistulas(85.48%);T2WI sequence showed 37 internal openings(86.05%)and 55 fistulas(88.71%);T2WI lipid suppression sequence showed 41 internal openings(95.35%)and 59 fistulas(95.16%);DWI sequence showed 42 internal openings(97.67%)and 60 fistulas(96.77%);and the enhanced scan sequence showed 42 internal openings(97.67%)and 61 fistulas(98.39%).The difference in the detection accuracy of internal orifice and fistula between DWI and T2WI lipid suppression sequence was not statistically significant(P>0.05).The difference in the detection accuracy of internal orifice and fistula by comparing the enhanced scanning sequence with T2WI lipid suppression sequence and DWI was not statistically significant(P>0.05).The enhanced scanning sequence had higher detection accuracy of internal orifice and fistula than T1WI and T2WI sequences,and the difference was statistically significant(P<0.05).Conclusion 3.0 T multi-sequence MRI has outstanding imaging results in the diagnosis and classification of anal fistula.It can clearly show the position of internal orifice and fistula.It has outstanding significance in the examination of complex anal fistula,so it plays a guiding role in the surgical operation of anal fistula.