MRI联合瘘口X线造影诊断肛门闭锁的价值  

The value of diagnosis of imperforate anus by joint fistula radiography and magnetic resonance imaging

作　　者：靳瑞娟[1] 陈小龙[2] 孙多成[1] 李福彰[1] 夏雨[1] 靳秀丽[3] 

机构地区：[1]中山市博爱医院医学影像中心,广东中山528403 [2]陕西省人民医院医学影像中心,陕西西安710068 [3]川北医学院第二临床医学院.南充中心医院影像中心,四川南充637000

出　　处：《西部医学》2017年第10期1457-1460,共4页Medical Journal of West China

基　　金：广东省中山市卫计局科研项目(J2012087)

摘　　要：目的探讨MRI联合X线瘘口造影在诊断肛门闭锁中的价值。方法 16例肛门闭锁合并直肠会阴瘘患儿,体表瘘口注入20ml生理盐水后常规采用MRI检查,并与瘘口造影进行对比。23例结肠造瘘口造影采用球囊导尿管加压注射造影剂后多方位摄片。结果 16例合并直肠会阴瘘患儿MRI可以显示分型及瘘口位置,准确性达100%,有助于显示骶部、神经管及生殖道畸形,而9例通过瘘口造影发现异常通道并显示走形。23例结肠造瘘口造影,10例对肛门成形术后通道的通畅情况显示良好,11例术前发现异常通道,1例合并巨结肠,1例合并结肠狭窄。结论低场MRI改良扫描方法后联合瘘道造影诊断肛门闭锁,提高了显示性能。结肠造瘘口造影对肛门成形手术前后均有重要意义。Objective To discuss the value of diagnosis of imperforate anus by joint fistula radiography and mag- netic resonance imaging （MRI）. Methods 16 children with anal atresia and rectum perineum fistula were examined by MRI, which were compared with fistula radiography scanned after injection of about 20 ml saline through the body sur- face fistula. 23 children would adopt multi-azimuth radiography after adding pressure injecting contrast agent through the colostomy by balloon catheter. Results 16 cases with rectal perineum fistula displayed the position of fistula and classify type by MRI. The accuracy of diagnosis was 100%. It was helpful to display the malformation of lumbosacral region, neural tube and genital tract. 9 cases were discovered connection of fistula abnormal channel by fistula radiography. 23 cases were treated with colostomy radiography. 10 cases showed good about the channel flow conditions of plastic opera- tion. 11 cases were found the abnormal channel before the imperforate anus plastic operation, 1 case with the megacolon and 1 case with the colon stenosis. Conclusion Diagnosing the imperforate anus by using low-field MRI improved scan- ning methods and fistula radiography can improve the display performance. Colostomy radiography has the important meaning before and after the imperforate anus plastic operation.

关 键 词：磁共振成像 X线造影 瘘道 结肠造口术 肛门闭锁 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]