磁共振成像对肛瘘及其分型的诊断价值

目的旨在探讨MRI对肛瘘的分型及诊断准确率方面的价值。方法收集92例MRI诊断为肛瘘患者,所有病例均行MR平扫+增强检查,并经手术证实。根据Parks分型法,观察其MRI表现,与手术所见对照,评价MRI对肛瘘的分型及瘘管、内口、支管、脓肿的诊断准确性。结果 92例瘘管MRI表现:T2WI及T2WI-fs为高信号,T1WI呈条状等到或稍低信号,增强扫描瘘管壁有明显强化,并能显示病变内口和脓肿。MRI诊断为约肌间型35例、经括约肌型18例、括约肌上型4例、括约肌外型3例、皮下型7例、复杂型肛瘘25例,与手术所见对照,准确率为96.7%(89/92);显示肛瘘内口、主管、支管和脓肿准确率分别为97.1%、98.3%、80.7%和100%。结论 MRI对肛瘘的术前PARK分类与手术结果基本一致,能为手术提供准确解剖学依据,具有应用价值。

MRI Values of Diagonsing in Anal Fistulas and its Typing

Objectives To evaluate MRI values in diagnosing anal fistulas and the typing. Methods Ninety-two patients suffered from anal fistulas who experiened MR plane scan and enhanceinent were approved by operation.According to Parks type,the MRI manifestations were obsvered and collated with operation .The MRI correctness of the fistulas typing and dispaying the fistula, the internal opening ,primary tract, secondary tract, abscess were evaluated. Results The MRI manifestations of 92 cases： fistulas were high signals in T2WI and T2Wl-fs and were slightly low signals or middle signals in T IWI. The internal opening and abscess could be dispayed. The walls of fistula were evidently inten- sified after injecting contrast- agent.In type, 35 between sphincteric fistul, 18 transsphincteric,4 supra-sphincteric,3 extra-sphincteric, 7 enderinic and 25 complex anal fistula were diagnosed by MRI and the coincidental rate was 96.7%, 89/92. with surgical eomparying. The coincidental rates dispaying the internal opening ,primary tract, secondary tract and abscess were 97.1%, 98.3%, 81）.7% and 100% respectively. Conclusions MRI Parks typing of anal fistulas in operating-fiont was consistent with operating that could provide with correctly anatomical information for surgery and had applied values.