高场磁共振成像在肛瘘诊断中的应用价值

为探讨1．5T高场磁共振成像（MRI）在肛瘘诊断中的应用价值，对31例临床诊断为肛瘘的患者术前应用1．5T高场磁共振体部相控阵列线圈进行轴位、矢状位、冠状位的多种序列的检查。结果发现，MRI诊断结果与手术诊断结果完全一致，吻合率达到100％。其中经括约肌肛瘘9例，括约肌间肛瘘16例，括约肌外肛瘘1例，括约肌上肛瘘5例。单纯性肛瘘11例，复杂性肛瘘20例。MRI对瘘管显示的敏感度为100％；对脓肿显示的敏感度为100％；内口有2例为假阴性，对内口显示的敏感度为93．5％。结果表明，应用1．5T高场MRI能准确定位肛瘘的内口、瘘管的走向及其与肛管直肠括约肌之间的关系，具有重要的临床实用和推广价值。

Application of High Field MRI in the Diagnosis of Anal Fistula

The objective of this study was to explore the appliable value for diagnosing anal fistula with 1.5 T high field MRI. Thirty one patients with anal fistula which had been diagnosed clinically underwent multiple sections body phased array coil use of multiple sequences such as axial, sagittal and coronal sections of high field MRI preoperatively. As results, MRI diagnosis was completely identical to surgical diagnosis （100%） ;of the 31 eases,transsphincteric fistula was in 9 cases,intersphineteric fistula in 16 cases,extrasphincteric fistula in 1 case,suprasphineteric fistula in 5 cases. Simple anal fistula was revealed to be 11 cases and complicated to be 20 cases. MRI sensitivity to the fistula was 100% ,to the abscess was also 100%, and to the internal opening was 93.5% （2 eases showed sham-negativity）. It is concluded that high： field MRI can ensure the location of the internal opening of anal fistula,of the run of fistula,and can expose the relation between the fistula and the ano-rectal sphincter. The method has important value in clinic.