MRI不同序列成像在高原藏族肛周感染性疾病诊断和分型中的应用价值  

Application Value of Different MRI Sequences in Diagnosis and Classification of Perianal Infectious Diseases in Tibetan Plateau

作　　者：李作瑞 谢春 刘有云[1] 方靖[1] 刘香春[1] LI Zuorui;XIE Chun;LIU Youyun(Department of Radiology,Qinghai Provincial Hospital of Traditional Chinese Medicine,Xining,Qinghai Province 810000,P.R.China)

机构地区：[1]青海省中医院放射科,西宁810000 [2]青海省第五人民医院影像科,西宁810000

出　　处：《临床放射学杂志》2022年第12期2257-2262,共6页Journal of Clinical Radiology

基　　金：青海省医药卫生科技项目(编号:2019-wjzdx-91)。

摘　　要：目的分析MRI不同序列成像在高原藏族肛周感染性疾病诊断和分型中的应用价值。方法搜集2016年1月至2020年1月于本院就诊的肛周脓肿或肛瘘的69例患者,所有患者于术前行MRI检查,检查序列为轴位T_(1)WI、T_(2)WI、T_(2)WI-抑脂(FS)扫描,冠状位T_(2)WI及T_(2)WI-FS扫描,轴位、冠状位、矢状位T_(1)WI-FS增强MRI扫描。与手术病理结果进行比较,分析不同序列成像诊断各类型脓肿、肛瘘及内口的正确率,采用受试者工作特征(ROC)曲线分析MRI在高原藏族肛周感染性疾病诊断的应用价值。结果除矢状位序列的所有平扫及增强扫描序列诊断坐骨肛管间隙脓肿的正确率为100.00%。T_(2)WI-FS轴位平扫及增强扫描序列诊断括约肌间脓肿的正确率为100.00%。T_(2)WI冠状位及T_(1)WI-FS冠状位增强扫描序列诊断骨盆直肠间隙脓肿的正确率为100.00%。T_(2)WI-FS轴位平扫及T_(1)WI-FS轴位增强扫描序列诊断低位肛瘘的正确率均为100.00%。T_(2)WI冠状位及T_(1)WI-FS冠状位增强扫描序列诊断高位肛瘘的正确率均为100.00%。结合T_(1)WI图像的T_(2)WI-FS轴位诊断内口的正确率为88.41%,T_(1)WI-FS轴位增强扫描序列诊断强化内口的正确率为92.59%。T_(1)WI-FS冠状位增强扫描序列诊断6点和12点内口的正确率为90.00%。结合轴位T_(1)WI图像的T_(1)WI-FS轴位增强扫描+T_(1)WI-FS冠状位增强扫描联合诊断强化脓肿、肛瘘及内口的正确率分别为100.00%、100.00%及81.48%。ROC曲线分析得出,MRI诊断肛周脓肿的曲线下面积(AUC)为0.825,敏感度为86.34%,特异度为82.49%;MRI诊断肛瘘的AUC为0.743,敏感度为76.58%,特异度为74.12%;MRI诊断内口的AUC为0.689,敏感度为67.48%,特异度为62.58%。结论MRI轴位联合冠状位扫描,尤其是轴位联合冠状位T_(1)WI-FS增强扫描序列对诊断脓肿、肛瘘及内口等肛周感染性疾病的准确率较高,可为早期诊断肛周疾病提供有效的影像支持,可在临床中广泛�Objective To analyze the application value of different sequences of magnetic resonance imaging(MRI)in the diagnosis and classification of perianal infectious diseases in Tibetan Plateau.Methods 69 patients with perianal abscess or anal fistula in our hospital from January 2016 to January 2020 were selected.All patients underwent MRI examination before operation.The examination sequences were axial T_(1)WI,T_(2)WI,T_(2)WI-FS scan,coronal T_(2)WI and T_(2)WI-FS scanning,and axial,coronal and sagittal T_(1)WI-FS enhanced MRI scan.Compared with the results of operation and pathology,the correct rate of different sequence imaging in the diagnosis of various types of abscess,anal fistula and internal orifice was analyzed.The application value of MRI in the diagnosis of perianal infectious diseases in Tibetan Plateau was analyzed by ROC curve.Results Except for sagittal sequence,the accuracy rate of plain scan and enhanced scan sequence was 100.00%.The accuracy rate of T_(2)WI-FS axial plain scan and enhanced scan sequence was 100.00%.The correct diagnosis rate was 100%on T_(1)WI-FS and T_(2)WI.The accuracy of T_(2)WI-FS axial plain scan and T_(1)WI-FS enhanced scan sequence in the diagnosis of low anal fistula was 100.00%.The accuracy of T_(2)WI coronal and T_(1)WI-FS coronal enhanced sequences were 100.00%.Combined with T_(1)WI images,the accuracy of T_(2)WI-FS axial diagnosis of internal orifice was 88.41%,and the accuracy rate of T_(1)WI-FS axial sequence was 92.59%.The accuracy rate of T_(1)WI-FS coronal enhanced sequence was 90.00%.The correct rates of T_(1)WI-FS axial and T_(1)WI-FS coronal enhancement combined with axial T_(1)WI images were 100.00%,100.00%and 81.48%respectively.ROC curve analysis showed that the AUC of MRI in the diagnosis of perianal abscess was 0.825,the sensitivity was 86.34%,the specificity was 82.49%;the AUC of MRI in the diagnosis of anal fistula was 0.743,the sensitivity was 76.58%,the specificity was 74.12%;the AUC of MRI in the diagnosis of internal orifice was 0.689,the sensitivity wa

关 键 词：磁共振成像 序列成像 高原藏族 肛周感染性疾病 诊断 分型 价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R657.1[医药卫生—诊断学]