肠神经元发育异常症患儿盆底肌群的MRI应用研究  

The study of magnetic resonance imaging in intestinal dysganglionosis

作　　者：张丽[1] 江肖松 曾益辉 洪庆山[1] 唐雯 刘永熙[1] 梅世伟[1] 江魁明[1] Zhang Li;Jiang Xiaosong;Zeng Yihui;Hong Qingshan;Tang Wen;Liu Yongxi;Mei Shiwei;Jiang Kuiming(Department of Radiology,Guangdong Women and Children’s Hospital,Guangzhou 510011,China)

机构地区：[1]广东省妇幼保健院放射科,广州510011

出　　处：《国际医药卫生导报》2020年第15期2166-2169,共4页International Medicine and Health Guidance News

基　　金：广东省中医药局面上科研项目(20192011)。

摘　　要：目的探讨盆底MRI在小儿肠神经元发育异常症(intestinal dysganglionosis,IDs)中评估肛周肌群的应用价值。方法分析34例无直肠肛管疾病小儿及34例确诊为先天性巨结肠及巨结肠类缘病患儿的盆底MRI表现,对比观察肛提肌及肛门括约肌发育情况。结果无直肠肛管疾病儿童肛提肌及肛门括约肌均显示良好,形态规则,内部信号均匀。34例先天性巨结肠及巨结肠类缘病患儿中,HD患儿25例,HAD患儿9例。28例(82.35%)均显示扩张段及远端鸟嘴样狭窄的痉挛狭窄,30例(88.24%)可见扩张段肠壁不同程度的增厚。27例(79.41%)表现为盆底肌群形态异常。22例(64.71%)表现为肛门括约肌形态异常,两侧形态不对称,肌腹不规则增厚;5例(14.71%)表现为耻骨直肠肌形态异常,两侧肌腹不对称,一侧较另一侧不均匀增厚;7例(20.58%)表现为肛门括约肌、耻骨直肠肌形态对称规则,边缘光滑清楚,肌腹无明显增厚,内部信号均匀。结论MRI可清晰显示肛提肌及肛门括约肌的发育情况,且安全无辐射,为IDs患儿制定手术方案及评估预后提供重要的影像学支持。Objective To investigate the value of magnetic resonance imaging(MRI)in the evaluation of perianal muscles in intestinal dysganglionosis(IDs).Methods MRI was performed in 34 children with surgically proved IDs and 34 children without IDs,the development of levator ani muscle and anal sphincter muscle were analyzed.Results The development of levator ani muscle and anal sphincter muscle in children without anorectal diseases were demonstrated well using MRI.Of the 34 IDs cases,there were 25 cases of HD and 9 cases of HAD.There were 27 cases(79.41%)of poor development of levator ani muscle and anal sphincter muscle.22 cases(64.71%)manifested as irregular thickening of anal sphincter muscle shape with bilateral asymmetry.5 cases(14.71%)manifested as irregular thickening of puborectalis muscle shape with bilateral asymmetry.7 cases(20.58%)developed near-normal.Conclusion MRI can clearly show the development of levator ani muscle and anal sphincter muscle,safe and radiation-free,which provides important imaging support for the development of surgical plan and prognosis for children with IDs.

关 键 词：磁共振成像 肠神经元发育异常症 先天性巨结肠 巨结肠类缘病 肛提肌 肛门括约肌 

分 类 号：R725.7[医药卫生—儿科] R445.2[医药卫生—临床医学]