MRI增强检查在复杂性肛瘘诊断中的价值研究  

The value of enhanced MRI examination in the diagnosis of complex anal fistulas

作　　者：许辉 孔德伟[2] XU Hui;KONG Dewei(Department of Radiology,Shanghai Qingpu District Hospital of Traditional Chinese Medicine,Shanghai 201799,China;Department of Radiology,Longhua Hospital of Shanghai University of TCM,Shanghai 200032,China)

机构地区：[1]上海市青浦区中医医院放射科,上海201799 [2]上海中医药大学附属龙华医院放射科,上海200032

出　　处：《中国医药科学》2022年第15期142-146,共5页China Medicine And Pharmacy

基　　金：上海中医药大学附属龙华医院科研基金(2018YR03)。

摘　　要：目的 通过核磁共振(MRI)检查与手术检查结果对照研究,评价增强MRI在诊断复杂性肛瘘的影像特征、优势及不足。方法 选取2020年12月至2021年10月上海中医药大学附属龙华医院31例复杂性肛瘘住院患者行增强3.0 T MRI检查,得到瘘管类型、数目、形态、与括约肌的关系、内瘘口位置等诊断信息,并与手术结果比较。结果 复杂性肛瘘患者的MRI检查与手术探查结果在内瘘口数目和位置的诊断吻合度中等(P <0.05),MRI在复杂性肛瘘的内瘘口信息诊断的灵敏度为100.0%,特异度为78.6%,误诊率为21.4%,漏诊率为0;MRI与手术探查结果在主瘘管数目的诊断有较高的吻合度(P <0.05),两种方法间差异无统计学意义(P> 0.05)。MRI与手术探查对主瘘管分型的诊断、支瘘管数目和分型的诊断具有中等吻合度(P <0.05)。手术探查对支瘘管的分类优于MRI(P <0.05)。结论 MRI在复杂性肛瘘的诊断中具有很高的诊断价值,在主瘘管的诊断与手术检查结果一致,对于内瘘口及支瘘管显示及诊断的能力有待于加强。Objective To evaluate the imaging features, advantages and shortcomings of enhanced MRI in the diagnosis of complex anal fistulas through a controlled study of MRI examination results versus surgical exploration findings. Methods A total of 31 inpatients with complex anal fistulas from December 2020 to October 2021 at Longhua Hospital of Shanghai University of TCM were selected to undergo enhanced 3.0 T MRI examination, and diagnostic information such as fistula type, number, morphology, relationship with the sphincter muscle, and location of the internal orifice were obtained and compared with the surgical exploration findings. Results A moderate coincidence degree was found between MRI examination results and surgical exploration findings in the diagnosis of the number and location of internal orifice in patients with complex anal fistulas(P < 0.05). The sensitivity was 100.0%, specificity was 78.6%, rate of misdiagnosis was 21.4%, and rate of missed diagnosis was 0 for MRI in the diagnosis of complex anal fistulas. There was a high coincidence degree between MRI examination results and surgical exploration findings in the diagnosis of the number and location of the main fistula(P < 0.05), and there was no statistically significant difference between the two diagnostic methods(P > 0.05). There was a moderate coincidence degree between the MRI examination and surgical exploration methods in the diagnosis of the main fistula classification and the number and classification of the sub-fistula(P < 0.05). Surgical exploration was superior to MRI examination in the diagnosis of the subfistula classification(P < 0.05). Conclusion MRI has high diagnostic value in the diagnosis of complex anal fistulas, and its diagnostic results in the main fistula are in agreement with the surgical exploration findings, but its ability to show and diagnose the internal orifice and sub-fistula needs to be improved.

关 键 词：核磁共振 复杂性肛瘘 增强检查 瘘管类型 

分 类 号：R445[医药卫生—影像医学与核医学] R657.16[医药卫生—诊断学]