3D-SPGR增强序列在肛瘘诊断中的价值  

Value of 3D-SPGR Sequence in Diagnosis of Anal Fistula

作　　者：邵继满[1] 陈志坚[1] 万小玲[1] 卜军[1] 肖慧荣[1] 

机构地区：[1]江西中医药大学附属医院放射科,南昌330006

出　　处：《实用临床医学（江西）》2015年第8期83-85,89,共4页Practical Clinical Medicine

基　　金：江西省卫生厅科技计划(20141104)

摘　　要：目的通过钆增强三维损毁梯度回波(3D-SPGR)序列与其他常规MRI序列比较,评估增强3D-SPGR序列在肛瘘诊断中的临床应用价值。方法对97例肛瘘患者术前均行MRI平扫及增强扫描,序列包括矢状位T2加权成像(Sag T2WI)、冠状位T2WI抑脂(Cor T2WI FS)、横断位T2WI(Ax T2WI)、横断位T2WI抑脂(Ax T2WI FS)和钆增强三维损毁梯度回波(3D-SPGR)。评估和比较MRI各序列显示的瘘管、内口、瘘管分支及脓腔。结果97例患者中内口和主瘘管117个,支瘘管143个。1级肛瘘12例,2级肛瘘11例,3级肛瘘11例,4级肛瘘39例,5级肛瘘24例。MRI各序列结果显示,97例患者3D-SPGR显示内口和瘘管、支瘘管的阳性率均明显高于Sag T2WI、AX T2WI、AX T2WI FS、Cor T2WI及Cor T2WI FS(均P<0.05)。结论钆增强3D-SPGR序列可提高肛瘘诊断的准确率,能够为外科手术方式的选择提供较详尽的影像资料。Objective To assess the clinical value of gadolinium-enhanced three dimensionspoiled gradient（3D-SPGR）sequence in the diagnosis of anal fistula through comparing with other conventional MRI sequences.Methods Unenhanced and contrast-enhanced MRI were performed in 97 patients with anal fistula.The MRI sequences included sagittal T2WI（Sag T2WI）,coronal T2 WI with fat suppression（Cor T2 WI FS）,axial T2WI（Ax T2WI）,axial T2 WI with fat suppression（Ax T2 WI FS）,and 3D-SPGR.MRI manifestations of fistula,endostoma,fistula branch and vomica were compared with the operation results.Results There were 117 endostomas and main fistulas and 143 fistula branches in the 97 patients.Among these patients,12 had grade 1anal fistula,11 had grade 2anal fistula,11 had grade 3anal fistula,39 had grade 4anal fistula,and 24 had grade 5anal fistula.Compared with Sag T2 WI,AX T2 WI,AX T2 WI FS,Cor T2 WI or Cor T2 WI FS,3D-SPGR showed a significant increase in the positive rates of endostoma,main fistula and fistula branch（P〈0.05）.Conclusion Gadolinium-enhanced 3D-SPGR improves the diagnosis accuracy of anal fistula,and provides detailed image data for the choice of surgical approach.

关 键 词：肛瘘 钆增强 三维损毁梯度回波 磁共振成像 诊断 

分 类 号：R814.42[医药卫生—影像医学与核医学] R657.16[医药卫生—放射医学]