磁共振多模态成像在肛瘘诊断中的应用价值

目的探讨磁共振不同序列对于肛瘘诊断价值的差异。方法回顾性分析43例经手术病理证实为肛瘘的病人，术前均行MRI检查，以手术病理结果为金标准，比较分析3种不同MRI序列对肛瘘征象的显示和诊断价值。结果在主瘘管(包括脓肿)的诊断方面，T2WI的正确率为96.7%，T2WI-FS为95.1%，T1WI-FS增强为96.7%，差异无统计学意义(P>0.05)；在肛瘘内口的诊断上，T2WI和T1WI-FS增强序列的准确率均为98.0%、T2WI-FS为86.3%，差异有统计学意义(P < 0.05)；而在继发/分支/细小瘘管的诊断方面，T2WI和T2WI-FS准确率均为76.7%，T1WI-FS增强为95.3%，差异有统计学意义(P < 0.01)；此外，3种扫描序列对于肛瘘内口和瘘管显示的清晰度评分差异无统计学意义(P>0.05)。结论MRI多模态成像可以对肛瘘的主要征象清晰地显示，T2WI和T1WI-FS增强序列对于病灶的整体解剖结构更好，其中T1WI-FS增强序列可以对更细微的病灶进行显示。

Application value of multi-parameter MRI in the diagnosis of anal fistula

ObjectiveTo investigate the value of different MRI sequences in the diagnosis of anal fistula.MethodsThe clinical data of 43 patients with anal fistula confirmed by surgery and pathology were retrospectively analyzed.The MRI examination in all patients were implemented before surgery.Using the surgical pathological results as the gold standard, the signs and diagnostic value of three different MRI sequences in anal fistula were compared and analyzed.ResultsIn the diagnosis of main fistula(including abscess), the accuracy of T2WI, T2WI-FS and T1WI-FS was 96.7%, 95.1% and 96.7%, respectively, and the differences of which were not statistically significant(P>0.05).In the diagnosis of anal fistula, the accuracy of T2WI and T1WI-FS enhanced sequences was 98.0% and 86.3%, respectively, and the differences of which were statistically significant(P < 0.05).In the diagnosis of secondary/branch/small fistula, the accuracy of T2WI and T2WI-FS was 76.7%, and the T1WI-FS enhancement was 95.3%, and the differences of which were statistically significant(P < 0.01).In addition, there was no statistical significance in the articulation score of three scanning sequences in the internal anal fistula and fistula(P>0.05).ConclusionsThe MRI can clearly show the main signs of anal fistula.The T2WI and T1WI-FS enhanced sequences are better for the overall anatomical structure of the lesion, and the T1WI-FS enhanced sequences can display the more subtle lesions.