正常成人肛周肌群的体外相控阵线圈高分辨率磁共振成像  

Magnetic resonance imaging of anal canal using high-resolution sequences and phased array coil: visualization of perianal muscles

作　　者：张建军[1] 马国骏[1] 赵秋枫[1] 孔德伟[1] 王嵩[1] ZHANG Jianjun;MA Guojun;ZHAO Qiufeng;KONG Dewei;WANG Song(Department of Radiology,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院放射科,上海200032

出　　处：《肿瘤影像学》2018年第6期461-465,共5页Oncoradiology

基　　金：上海市卫生和计划生育委员会科研课题(201540198)

摘　　要：目的:探讨体外相控阵线圈高分辨率磁共振成像(magnetic resonance imaging,MRI)对正常成人肛周肌群的显示及应用价值。方法:使用腹部体外相控阵线圈对38例正常成人[16例男性,22例女性,平均年龄为(56.3±19.7)岁]行肛周MRI。观察耻骨直肠肌与肛提肌及肛门外括约肌的关系、肛门外括约肌的分部及联合纵肌的构成。测量肛管、外括约肌及耻骨直肠肌长度,以及耻骨直肠肌和肛门内外括约肌厚度,并比较不同性别组之间的差异。结果:38例正常志愿者肛周MRI对耻骨直肠肌、肛提肌及肛门内外括约肌均能清晰地显示。耻骨直肠肌与其上方的肛提肌及下方的肛门外括约肌深部之间有脂肪间隙分隔,属于独立的结构。肛门外括约肌分为深部、浅部及皮下部3部分。肛门内外括约肌间的括约肌间隙内可见两层纵行的纤维。男性的外括约肌厚度为(4.1±0.7)mm,较女性的(3.4±0.6)mm厚(P=0.003)。男性与女性之间肛管、外括约肌、耻骨直肠肌长度,以及耻骨直肠肌和内外括约肌厚度差异无统计学意义(P>0.05)。结论:体外相控阵线圈高分辨率MRI可清晰地显示肛周肌群及其周围间隙,为肛周疾病的诊断和治疗提供精确的解剖学信息。Objective:To evaluate the normal anatomy of perianal muscles using high-resolution magnetic resonance imaging(MRI)with phased array coil.Methods:A total of 38 normal adults[16 males and 22 female,media age(56.3±19.7)years]underwent anal MRI with an abdominal phased array coil.The relationship among puborectalis muscle,levator ani muscle and external anal sphincter,fiber bundles of external anal sphincter and components of conjoint longitudinal muscle were analyzed.The length of anal canal,external anal sphincter and puborectalis muscle,the thickness of puborectalis muscle,external anal sphincter and internal anal sphincter were measured.The differences between males and females were compared.Results:Optimal image quality of puborectalis muscle,levator ani muscle,internal anal sphincter and external anal sphincter was obtained in all cases.Puborectalis muscle was an independent structure,with fat spaces separating among the superior levator ani muscle and inferior external anal sphincter.External anal sphincter had three separated muscular fiber bundles:deep,superficial and subcutaneous.Two longitudinal muscle layers were in the space between external anal sphincter and internal anal sphincter.The thickness of external anal sphincter in males[(4.1±0.7 mm)]was greater than that in females[(3.4±0.6)mm](P=0.003).There was no significant difference in the length of anal canal,external anal sphincter and puborectalis muscle,and the thickness of puborectalis muscle,internal anal sphincter and external anal sphincter between males and females(P>0.05).Conclusion:High-resolution mri with phased-array coil can display the anal canal and perianal structures in great detail,which will provide valuable information for the diagnosis and treatment of anal diseases.

关 键 词：正常成人 肛周肌群 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]