磁共振成像在复杂性肛瘘诊断中的价值及临床应用

目的运用磁共振体线圈成像技术检查复杂性肛瘘,探讨磁共振成像(MRI)在复杂性肛瘘诊断中的价值。方法22例临床诊断为复杂性肛瘘的患者术前进行磁共振相控阵列线圈检查。以手术结果为标准,比较术前指诊检查和MRI检查结果。结果在22例术前诊断为复杂性肛瘘的患者中,经MRI检查显示:18例为复杂性肛瘘,3例(2例为黏液腺癌,1例为恶性黑色素瘤)表现为肛瘘伴局部占位性病变,1例为骶前囊肿。18例复杂性肛瘘中,经括约肌肛瘘3例,括约肌上肛瘘11例,括约肌外肛瘘4例。以手术结果为标准,术前指诊检查结果与MRI检查结果相比较:内口定位准确率为33.3%比72.2%(P=0.019),支管和脓腔定位准确率为16.7%比88.9%(P=0.000),MRI检查的准确率明显高于术前指诊检查,其差异有统计学意义;主管道定位准确率为83.3%比100%,差异无统计学意义(P=0.072)。结论体线圈MRI能准确定位复杂性肛瘘的内口、主管道、支管和脓腔,能较为准确地显示复杂性肛瘘与肛管直肠括约肌复合体之间的复杂关系。同时,应用MRI检查可以排除其他潜在病变。

Clinical Application and Value of MRI on Diagnosis of Complex Anal Fistulas

Objective To evaluate the value of magnetic resonanace imaging (MRI) on the diagnosis of complex anal fistula. Methods The preoperative digital examination and MRI with the phased-array coil were implemented for 22 patients who were clinically suspected with complex anal fistula. The final diagnosis were based on surgical findings. Outcomes of MRI and digital examination were compared with surgical results. Results Eighteen patients were diagnosed as complex anal fistula,1 case of presacral cyst and 3 cases...