男性盆腔MRI多序列成像对肛周脓肿位置及肛瘘诊断分型中的临床应用价值  

Clinical value of male pelvis multi-sequence MRI in diagnosis of perianal abscess location and anal fistula classification

作　　者：夏蕾 王孝磊[1] 苗珂 丁玉姣 徐秋贞[1] XIA Lei;WANG Xiao-lei;MIAO Ke;DING Yu-jiao;XU Qiu-zhen(Department of Radiology,Zhongda Hospital Southeast University(Jiangbei),Nanjing 210044,Jiangsu,China)

机构地区：[1]东南大学附属中大医院江北院区放射科,江苏南京210044

出　　处：《生物医学工程与临床》2022年第5期567-571,共5页Biomedical Engineering and Clinical Medicine

基　　金：江苏省医学会伦琴影像科研专项资金项目(SYH-3201150-009)。

摘　　要：目的 分析男性盆腔 MRI 多序列成像对肛周脓肿位置及肛瘘分型的诊断价值。 方法 选择 2017 年 6 月至 2021年 1 月在东南大学附属中大医院放射科诊治的疑似肛周脓肿及肛瘘的男性患者 107 例,年龄 20 ~ 58 岁,平均年龄 38.5岁;体质量指数(BMI)18.6 ~ 26.4 kg/m^(2),平均 BMI 21.8 kg/m^(2);病程 1 个月 ~ 12 年,平均病程 3.2 年。 均采用盆腔 MRI 多序列成像进行诊断,并经手术及病理组织学检查,然后对患者肛周脓肿与肛瘘的 MRI 表现及手术病理结果进行分析,并分析 MRI 多序列成像对肛周脓肿位置、 脓肿分型及肛瘘分型诊断的准确度。 结果 107 例疑似肛周脓肿及肛瘘的患者中,手术确诊肛周脓肿 96 例,合并肛瘘者 42 例;MRI 诊断为肛周脓肿 93 例,合并肛瘘者 40 例。 MRI 多序列成像对肛周脓肿位置诊断的灵敏度为 95.83 %,特异度为 90.91 %;MRI 对肛周脓肿分型诊断的灵敏度为 92.71 %,特异度为 63.64 %;MRI 多序列成像对肛瘘分型诊断的灵敏度为 92.86 %,特异度为 98.46 %。 MRI 显示脓肿壁较厚,形态为类圆形、马蹄铁形或不规则形,与周围组织的分界不十分清楚,与同层肌肉相比,脓肿壁的 T加权成像(TWI)、T加权成像(TWI)呈低信号或等信号,中央脓腔为信号不均的脓性物质。 结论 男性盆腔 MRI 多序列成像对肛周脓肿位置及肛瘘分型的诊断价值较高,推荐在临床上应用。Objective To analyze the clinical value of male pelvis multi-sequence magnetic resonance imaging(MRI) in diagnosis of perianal abscess location and anal fistula classification. Methods From June 2017 to January 2021, a total of 107male patients with suspected perianal abscess and anal fistula were enrolled, which aged 20 - 58 years old with mean age of38.5 years old;body mass index(BMI) was 18.6 - 26.4 kg/m^(2)with mean BMI of 21.8 kg/m^(2);disease duration was 1-month to12-year with mean disease duration of 3.2-years. All of them were diagnosed by multi-sequence MRI, and further confirmed by operation and histopathology. Then MRI findings and surgical pathological results of perianal abscess and anal fistula were analyzed, and the accuracy of multi-sequence MRI in diagnosis of perianal abscess location, abscess classification and anal fistula classification was analyzed. Results Among 107 cases with suspected perianal abscess and anal fistula, 96 cases of perianal abscess and 42 cases combined with anal fistula were diagnosed by operation, 93 cases of perianal abscess and 40cases combined with anal fistula were diagnosed by MRI. The sensitivity and specificity of multi-sequence MRI in diagnosis of perianal abscess were 95.83 % and 90.91 %, respectively. The sensitivity and specificity of multi-sequence MRI in diagnosis of perianal abscess classification were 92.71 % and 63.64 %, respectively. The sensitivity and specificity of multi-sequence MRI in classification diagnosis of anal fistula were 92.86 % and 98.46 %, respectively. MRI showed that the abscess wall was thick with round like, horseshoe shaped or irregular, and the boundary between abscess wall and adjunction tissues was unclear. Compared with same layer of muscle, the Tweighted imaging(TWI) and Tweighted imaging(TWI) of abscess wall showed low signal or equal signal, and the central abscess cavity was purulent material with uneven signal. Conclusion It is demonstrated that male pelvic MRI multi-sequence imaging has higher diagnostic value in perianal

关 键 词：磁共振成像(MRI) 肛周脓肿 肛瘘 影像特征 诊断价值 

分 类 号：R657.15[医药卫生—外科学] R445.2[医药卫生—临床医学]