肛瘘MRI术前诊断价值与术中结果对照分析

【摘要】〓目的〓探讨术前磁共振(MRI)检查对肛瘘的定位、分型的临床指导意义。方法〓50例肛瘘患者行MRI检查,根据MRI所见,定位瘘道位置,依据窦道与肛门内外括约肌关系进行分型,并与术中所见结果相对照。结果〓手术证实50例患者中,30例为单纯性肛瘘,20例为复杂性肛瘘。括约肌间型20例,经括约肌型12例,括约肌上型6例,括约肌外型3例,表浅型9例。原发性瘘管72个,内口78个,外口77个,肛周脓肿17个。MRI诊断原发瘘管、内口、肛周脓肿的灵敏度分别为93.1%、96.2%、100%,特异度分别为91.5%、97.5%、91.3%。结论〓MRI可准确地判断肛瘘的分型、瘘管数量、走行、支管、内口的位置及有无肛周脓肿形成,为临床手术治疗提供重要指导信息。

Preoperative MRI diagnosis of anal fistula and compares with surgical results

Objective To explore the application value of the preoperative magnetic resonance imaging （MRI） in diagnosis of anal fistula location and type. Methods Fifty cases of anal fistula were examined by MRI. According to MR findings, the position of fistula and the relationship with the sinus and external anal sphincter were analyzed. Then the MR findings were contrasted with surgical results. Results The imaging of MRI all accorded with the clinical diagnosis, including 30 cases of simple anal fistula, 20 cases of complex anal fistulas. Among 50 cases, intersphincteric fistulas were 20 cases, trans-sphincteric fistulas 12 cases, suprasphincteric fistulas 6 cases, extrasphincteric fistulas 3 cases, and superficial fistulas 9 cases. A total of 72 primary fistulas, 78 interned openings, 77 extended openings, and 17 perianal abscesses were found. The sensitivity of MRI diagnosis for primary fistula, interned opening and perianal abscess were respectively 93.1%, 96.2%, 100% and specificity were 91.5%, 97.5%, 91.3%. Conclusion MRI can accurately determine the type of anal fistula, fistula number, course, branch, the location of interned opening and the presence of the abscess formation, providing important guidance for clinical surgery.