肛周脓肿的磁共振成像研究  

Magnetic resonance imaging study of perianal abscess

作　　者：李翔[1] 强金伟[1] 贺成[1] 吉学生[1] 张飚[1] 

机构地区：[1]复旦大学附属金山医院放射科复旦大学上海医学院影像学系,上海200540

出　　处：《中华胃肠外科杂志》2011年第11期868-870,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨磁共振成像（MRI）对肛周脓肿的诊断价值。方法回顾性分析2007年7月至2009年3月间复旦大学附属金山医院收治的50例肛周脓肿患者的临床和MRI影像学资料。按以下步骤进行MRI检查：横断面T1WI，横断面、冠状面和（或）矢状面T2WI抑脂序列平扫，横断面、冠状面和（或）矢状面增强扫描。分析脓肿的部位、大小、形态、信号和增强特征。结果50例患者通过MRI共检出51个脓肿病灶．脓肿在T1WI表现为等或略低信号，T2WI抑脂脓腔呈明显高信号。增强见脓肿壁明显强化。脓肿最大径（3．4±1．7）cm，脓腔最大径（2．7±1．7）cm。脓肿呈类圆形26个，长圆形18个，新月形7个：脓腔单房41个，多房10个。脓肿位于肛提肌下方、括约肌间沟上方23例．位于括约肌间沟下方3例．跨肛提肌及括约肌间沟1例，跨肛提肌7例，跨括约肌间沟16例，肛提肌上方1例。结论MRI能无创、方便、准确地诊断肛周脓肿，清晰显示脓肿与肛管结构的解剖关系。Objective To investigate magnetic resonance imaging （MRI） manifestations of perianal abscess and to evaluate MRI diagnosis for perianal abscess. Methods Fifty cases of perianal abscess between July 2007 and March 2009 were included in this study. MRI was performed using T1 weighted sequence in axial plane, T2 weighted sequence with fat saturation in axial, coronal and/or sagittal plane, and T1 weighted enhanced sequence with fat saturation in axial, coronal and/or sagittal plane. The location, size, shape, signal characteristics, and enhancement patterns of perianal abscess were analyzed. Results Fifty cases with 51 perianal abscesses were identified. The abscess appeared slight hypo- or isointense signal on T1 weighted imaging, obviously hyperintense signal at cavity and isointense singal at wall on T2 weighted with fat saturation imaging, and marked enhancement at wall. The largest diameters ranged between 0.5 cm and 9.0 cm （mean 3.4±1.7 cm ） in abscess, between 0.2 cm and 8.0 cm （mean 2.7±1.7 cm） in cavity. The abscess was round, oblong and crescent in 23, 18 and 7 cases respectively, and was unilocular in 41 cases and multilocular in 10 cases. The abscess located between levator ani and intersphincteric groove in 23 cases, under intersphincteric groove in 3 cases, across levator ani and intersphincteric groove in one case, on levator ani in 7 cases, on intersphincteric groove in 16 cases and above levator ani in one case. Conclusion MRI is a noninvasive, convenient and highly accurate procedure for diagnosing perianal abscess, which can demonstrate the anatomical relationship between abscess and anal canal.

关 键 词：肛周脓肿 磁共振成像 诊断 

分 类 号：R657.1[医药卫生—外科学]