多排螺旋CT三维重建在复杂性肛瘘定位诊断中价值

目的探讨多排螺旋CT三维重建在复杂性肛瘘定位诊断中的临床应用价值。方法复杂性肛瘘患者18例，瘘管造影后行多排螺旋CT扫描，将原始数据进行曲面重建（curved planar reconstruction，CPR）和容积重建（volume rendering，VR），并与术后结果进行对照，分析多排螺旋CT三维重建技术用于肛瘘定位、分型的准确性。结果多排螺旋CT准确诊断低位复杂性肛瘘12例，高位复杂性肛瘘6例，其中2例高位复杂性肛瘘误诊为低位复杂性肛瘘，诊断准确率为88．9％；准确定位肛瘘内口29个，漏诊3个，定位准确率为90．6％；发现肛瘘支管38条，漏检3条，准确率为92．7％。结论瘘管造影后行多排螺旋CT三维重建可充分显示复杂性肛瘘的立体形态，为手术方案制定提供影像学依据。

Value of multi-slice spiral CT 3-dimensional construction technique to the localization diagnosis of complex anal fistulas

Objective To investigate clinical value of multi-slice spiral CT 3-dimensional reconstruction technique to the localization diagnosis of complex anal fistulas. Methods Eighteen patients with complex anal fistulas underwent multi- slice spiral CT scan after fistula angiography. The raw data were processed for curved planar reformation and volume rendering, which were compared with the surgical results. The accuracy of multi-slice spiral CT 3-dimensional reconstruction technique for location and classification of complex anal fistulas were analyzed. Results Multi-slice spiral CT showed complex low anal fistula in 12 cases, and complex high anal fistula in 6 cases, in which 2 cases of complex high anal fistula were missed diagnosed as complex low anal fistula, with the accuracy of 88. 9%. Twenty-nine fistula internal openings were accurately positioned, and 3 were missed diagnosed, with the positioning accuracy of 90. 6%. Thirty-eight fistula branches were found and 3 were missed diagnosed, with the accuracy of 92.7%. Conclusions The multi-slice spiral CT 3-dimensional reconstruction after fistula angiograpby can fully display the solid shape of complex anal fistula and provides the most detailed information for surgeon to formulate operation plan.