直肠内水囊填塞MRI诊断肛瘘类型的价值观察  

The Value of MRI with Water Plug in Rectum in the Diagnosis of Anal Fistula Type

作　　者：刘赟[1] 韩月蕊[1] LIU Yun;HAN Yue-rui(Department of General Surgery,Nanyang Central Hospital of Henan,Nanyang 473009,Henan Province,China)

机构地区：[1]河南省南阳市中心医院普通外科,河南南阳473009

出　　处：《中国CT和MRI杂志》2022年第7期166-167,182,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨直肠内水囊填塞MRI对术前肛瘘类型的诊断价值。方法从2019年1月至2020年1月在本院肛肠外科住院并准备接受手术治疗的疑似肛瘘患者中选出52例作为研究对象,所有患者术前均行MRI检查,检查序列包括T;WI横断面,T;WI的横断面、矢状面、冠状面,以手术诊断为“金标准”。比较水囊放置前后肛瘘的瘘管及分支、内口、脓肿的MRI影像学特征及MRI分型的符合率。结果肛瘘瘘管及分支在T;WI脂肪抑制序列呈条状高信号,T;WI呈条状低信号,增强扫描后管壁强化;内口在T;WI脂肪抑制序列呈点状高信号,增强扫描后强化;脓肿在T;WI脂肪抑制序列呈片状高信号,T;WI呈片状低信号,脓肿壁明显强化,中央脓腔呈低信号。与手术“金标准”比较,水囊放置.前MRI对.瘘管及分支、脓肿的诊断符.合率分别.为9315%、8500%,与水囊放置后.的9726%、9000%比较,差异无统计学.意义(P>005),水囊放置前的内口诊断符合率为.7500%,水囊放置后MRI对内口诊断符合.率为9038%,两组比较差异具有统计学意义(P.<005);水囊放置前MRI对肛瘘分型的符合率为7115%.(37/52),水囊放置后MRI对肛瘘分型的符合率为9.231%(48/52),两组比较差异具有统计学意义(P<005)。结论直肠内水囊填塞使得MRI检测能够更好地分辨肛瘘的瘘管及分支、内口、脓肿,术前诊断肛瘘类型的准确率更高,值得临床推广。Objective To investigate the value of MRI with water plug in rectum in the diagnosis of anal fistula type. Methods 52 patients with suspected anal fistula who were hospitalized in the Anorectal surgery Department and prepared to undergo surgery in the hospital between January 2019 and January 2020 were selected as the study subjects. All patients were examined by MRI before surgery, and the sequences included T1WI cross-section, T2WI cross-section, sagittal plane and coronal plane. With surgical diagnosis as the golden standard, the MRI characteristics of the fistula and its branches, inner opening and abscess of the anal fistula, and the coincidence rate of MRI classification were compared before and after placement of the water plug. Results The fistula and branches of anal fistula showed strip-like high signals on T2WI fat-suppression sequence and strip-like low signals on T1WI. Enhanced scan showed enhancement of the fistula wall. The inner opening showed point-like high signals on T2WI fat-suppression sequence, with enhancement after enhanced scan. Abscess showed patchy high signals on T2WI fat-suppression sequence, patchy low signals on T1WI, obvious enhancement of the abscess wall, and low signals of the central abscess cavity. Compared with the golden standard, there were no significant differences in the diagnostic coincidence rates of MRI for fistula and its branches and abscesses before and after placement of water plug(93.15%, 85.00% vs. 97.26%, 90.00%). There were significant differences in the diagnostic coincidence rates of MRI for internal opening and anal fistula type before and after the placement of water plug [75.00%, 71.15%(37/52) vs. 90.38%, 92.31%(48/52)](P<0.05). Conclusion MRI with water plug in rectum can better distinguish the fistula and its branches, internal opening and abscess of anal fistula, and improve the accuracy of preoperative diagnosis of anal fistula type.

关 键 词：直肠 水囊填塞 磁共振成像 诊断 肛瘘类型 

分 类 号：R657.1[医药卫生—外科学] R445.2[医药卫生—临床医学]