肛瘘MRI结构式报告对肛瘘的术前诊断价值  

Preoperative diagnostic value of MRI structured report for anal fistula

作　　者：陈琪 杨影 葛芳清[1] 刘灵灵[1] CHEN Qi;YANG Ying;GEFang-qing(Department of Radiology,Nantong Hospital of Traditional Chinese Medicine,Jiangsu 226000,China)

机构地区：[1]南通市中医院影像科,江苏226000 [2]南通市肿瘤医院/南通大学附属肿瘤医院影像科,江苏226000

出　　处：《放射学实践》2024年第5期647-651,共5页Radiologic Practice

基　　金：南通市卫生健康委员会科研立项课题(QA2021021)。

摘　　要：目的:探讨肛瘘MRI结构式报告对肛瘘的术前诊断价值。方法:选取156例经手术证实的肛瘘患者,术前行肛瘘多模态MRI检查,根据术前MRI贡献分为对临床有显著价值组(91例)与无显著价值组(65例),将肛瘘不同分型、瘘管数量、外口、是否累及肛提肌等因素采用Pearson卡方检验或Fisher精确检验进行组间比较,当结果差异有统计学意义时,采用Bonferroni校正后进一步行多重比较。结果:87.8%的患者术前肛瘘MRI结构式报告内容与手术结果相符,临床医生结合肛瘘MRI结构式报告后使37.8%的患者改变手术方式。MRI结构式报告对于复杂性肛瘘、Parks 4型或合并多种类型、累及肛提肌患者的术前诊断价值更高。其中肛瘘不同分型、瘘管数量及肛提肌是否受累在临床有显著价值组与无显著价值组间差异有统计学意义(P<0.005)。结论:肛瘘MRI结构式报告可以完善评估瘘管的解剖结构及相关并发症,在复发、复杂、高级别肛瘘术前评估中价值更高,可为肛瘘手术提供重要的参考信息。Objective:To investigate the preoperative diagnostic value of magnetic resonance imaging(MRI)structured report for anal fistula.Methods:A total of 156 cases with anal fistula confirmed by surgery were collected,and all performed anal fistula multimodal MRI examination before operation.Two study groups were formed according to the contribution of preoperative MRI:significant contribution group(91 cases)and nonsignificant contribution group(65 cases).Pearson Chi-square test or fisher exact test were used to compare the factors of different types of anal fistulas,number of fistulas,external opening and involvement of levator ANI muscle between groups.When there were significant differences in the results,multiple comparisons were further conducted after bonferroni correction.Results:The MRI structured report of anal fistula was consistent with the results of surgery in 87.8%of patients,and 37.8%of patients changed the surgical method after the clinician combined the MRI structured report of anal fistula.The MRI structured report was more valuable in preoperative diagnosis for patients with complex anal fistula,Parks 4 type or multiple types and involving levator ANI muscle.Among them,different types of anal fistulas,number of fistulas and involvement of levator ANI muscle were statistically significant between the two groups(P<0.005).Conclusion:MRI structured report of anal fistula can improve the evaluation of fistula anatomical structure and related complications.It is of higher value in preoperative evaluation of recurrent,complex and high-grade anal fistula,and provides important reference value for anal fistula surgery.

关 键 词：肛瘘 瘘管 磁共振成像 结构式报告 手术方式 

分 类 号：R574.8[医药卫生—消化系统] R445.2[医药卫生—内科学]