磁共振成像在肛瘘诊断中的应用价值

目的探讨体外相控阵线圈高分辨率MRI对肛周窦道及瘘管诊断的准确性及其应用价值。方法经手术证实的肛瘘患者64例,术前全部行MRI检查,检查序列主要包括矢状面、冠状面快速自旋回波(turbo spin-echo,TSE)T2加权成像(T2 weighted image,T2WI),轴位自旋回波(Spin-echo,SE)T1加权成像(T1 weighted image,T1WI)及脂肪抑制质子强度加权成像(proton density weighted image,PDWI),将影像学诊断与手术结果进行比较。结果 64例肛瘘共74个原发瘘管,89个内口,80个外口,48个肛周脓肿。MRI对原发瘘管、肛周脓肿、内口显示的灵敏度分别为95.8%、100%和94.3%,特异度分别为85.7%、97.5%和92.3%。结论 MRI可准确地判断肛瘘的分型、瘘管走行、有无脓肿和支管形成及肛瘘内口的位置,为中医临床治疗提供重要指导信息。

Diagnosis of anal fistulas with MR imaging

Objective To evaluate the accuracy and clinical value of preoperative high-resolution magnetic resonance imaging with a phased-array coil for the diagnosis of anal fistulas.Methods A total of 64 patients with anal fistulas surgically proved underwent preoperative MR imaging.MR scan sequence were contained such as the fast spin echo T2WI at sagittal and coronal planes,and spin echo T1WI、fast spin echo T2WI and PDWI with fat suppression at axial plan.MRI findings were analyzed by comparing with the surgical results.Results 64 patients were found to have 74 primary fistulas,89 internal openings,80 external openings,and 48 perianal abscesses.The sensitivity and specificity for detecting primary stula tracks、abscesses and internal openings,were 95.8% and 85.7%,100% and 97.5%,94.3% and 92.3%,respectively.Conclusions MRI is accurate for the classification and primary fistula tracks anal fistulas,perianal abscesses and internal openings.