肛管直肠周围脓肿MRI多序列成像与手术结果的对比研究  

Assessment of anorectal abscess with multi-sequence magnetic resonance imag⁃ing:comparison with surgical findings

作　　者：李馨 朱寅虎 金大永 江泊源 林婉林 钱一帆 田娟 秦越 陈文平 Li Xin;Zhu Yinhu;Jin Dayong;Jiang Boyuan;Lin Wanlin;Qian Yifan;Tian Juan;Qin Yue;Chen Wenping(Department of Radiology,Xi’an Daxing Hospital,Xi’an 710016,Shaanxi,China;Department of Anorectal and Pelvic Floor Surgery,Xi’an Daxing Hospital,Xi’an 710016,Shaanxi,China)

机构地区：[1]西安大兴医院影像科,陕西西安710016 [2]西安大兴医院肛肠盆底外科,陕西西安710016

出　　处：《结直肠肛门外科》2020年第6期723-725,733,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨术前MRI多序列成像在肛管直肠周围脓肿诊断中的临床应用价值。方法纳入我院52例临床诊断为肛管直肠周围脓肿并行MRI检查的患者为研究对象,将术前MRI诊断与手术结果进行对比分析,评估MRI在术前诊断肛管直肠周围脓肿及其分型、内口中的准确性。结果52例患者术前MRI诊断为肛周脓肿16例,坐骨直肠间隙脓肿14例,括约肌间脓肿20例,黏膜下脓肿1例;术后诊断为肛周脓肿16例,坐骨直肠间隙脓肿14例,括约肌间脓肿20例,黏膜下脓肿2例。MRI漏诊黏膜下脓肿1例,诊断准确率为98.1%。术前MRI检出脓肿内口32例,术后证实脓肿内口36例,诊断准确率为88.9%。结论MRI多序列成像在术前肛管直肠周围脓肿的诊断方面具有较高的准确性,能提供肛管直肠周围脓肿分型及内口位置等信息,可为临床选择手术治疗方案提供辅助诊断价值较高的参考依据。Objectives To investigate the value of multi-sequence magnetic resonance imaging(MRI)in diagnosing anorectal ab⁃scess.Methods Fifty-two patients with anorectal abscess who underwent MRI in our hospital were included.Findings from pre⁃operative MRI were compared with surgical findings.The accuracy of MRI in the classification and identification of internal ori⁃fice of the anorectal abscess was analyzed.Results Of the 52 patients,preoperative MRI found perianal abscess in 16 patients,ischiorectal abscess in 14 patients,intersphincteric abscess in 20 patients,and submucosal abscess in one patient.Postoperative surgical findings revealed perianal abscess in 16 patients,ischiorectal abscess in 14 patients,intersphincteric abscess in 20 pa⁃tients,and submucosal abscess in two patients.MRI missed one submucosal abscess.The accuracy of MRI in diagnosing anorec⁃tal abscess was 98.1%.Preoperative MRI identified internal orifice in 32 patients.Surgical findings revealed 36 internal orifice.The accuracy of MRI in identifying internal orifice was 88.9%.Conclusion Multi-sequence MRI is accurate in the preoperative diagnosis of anorectal abscess.It provides useful information for the classification and identification of internal orifice of the ab⁃scess.It can be used as a diagnostic tool for surgery options for anorectal abscess.

关 键 词：肛管直肠周围脓肿 MRI 术前诊断 

分 类 号：R657.15[医药卫生—外科学]