MRI与瘘道造影对于复杂性肛瘘诊断的不同价值

目的:探讨MRI与瘘道造影对于复杂性肛瘘的不同诊断价值.方法:41例肛瘘患者,其中26例通过MRI检查,采用T1WI,T2WI及脂肪抑制序列,增强扫描,观察肛瘘的内口、分支及其与周围肌肉的关系;15例瘘道造影检查,观察瘘管走行、有无内口.结果:15例瘘道造影检查病例中,9例可见内口与肛管相通,6例为盲瘘;26例MRI检查病例中,24例可明确内口位置及数量,1例未见内口,1例未见外口;10例瘘道累及肛提肌,2例瘘道累及括约肌,1例瘘道累及闭孔内肌,与手术结果一致.结论:对于肛瘘的术前检查而言,瘘道造影和MRI有其不同的价值,瘘道造影可以作为MRI检查的有益补充;在大部分情况下,特别是对于复杂性肛瘘,MRI能提供比瘘道造影更为完善的肛瘘病变信息.

The Different Value of MRI and Fistula Imaging to Complex Anal Fistula

Objective:To discuss the different diagnostic value of MRI and fistula imaging to anal complexity.Methods:Among 41 anal patients,26 cases are examined by MRI through T1WI,T2WI and fat inhibit sequence to strengthen scan,which helps to check the inside openings,anal branch and the relationship with the surrounding muscle.Results:15 cases are examined by fistula imaging,and the observation of fistula route and whether it has an opening inside.Among 15 cases,which are examined by fistula imaging,9 cases has the connection of inside opening and anal tube,in which 6 cases are blind fistula.In 26 cases which are examined by MRI,24 cases can be sure the location of inside opening and number,on case without inside opening and one case without outside opening.10 cases are fistula involving the anus mention muscle,2 cases are fistula muscle involvement and one fistula involvement in closed pore muscle.With the same results of operation.Conclusion:For the preoperative examination,fistula imaging and MRI have different values.Fistula imaging can be the supplement of MRI;in most cases,especially for the anal complexity,MRI can provide more information of anal lesions than fistula imaging.