基于高分辨率MRI的三维可视化模型在复杂性肛瘘诊疗评价中的应用价值  

Application value of high-resolution MRI-based three-dimensional visualization model in the diagnostic and therapeutic evaluation of complex anal fistula

作　　者：邱勇刚 楼存诚[1] 黄成 汪鑫斌 董浩 余日胜[3] QIU Yonggang;LOU Cuncheng;HUANG Cheng;WANG Xinbin;DONG Hao;YU Risheng(Department of Radiology,the First People’s Hospital of Xiaoshan District,Hangzhou 311200,China;Department of Anorectal Surgery,the First People’s Hospital of Xiaoshan District,Hangzhou 311200,China;Zhejiang University School of Medicine,Hangzhou 310011,China)

机构地区：[1]杭州市萧山区第一人民医院放射科,浙江杭州311200 [2]杭州市萧山区第一人民医院肛肠外科,浙江杭州311200 [3]浙江大学医学院,浙江杭州310011

出　　处：《实用放射学杂志》2024年第7期1096-1099,共4页Journal of Practical Radiology

基　　金：杭州市医药卫生科技计划项目(B20200019);杭州市生物医药和健康产业发展扶持科技专项项目(2021WJCY229)。

摘　　要：目的建立基于高分辨率磁共振成像(HR-MRI)的复杂性肛瘘三维可视化模型,探讨其可行性及临床应用价值。方法回顾性分析26例复杂性肛瘘患者临床及影像资料,建立基于HR-MRI图像的三维可视化模型,分别由放射科、肛肠科医师在HR-MRI图像和三维可视化模型评估Parks分型、内口、外口、分支瘘管及脓肿,采用SPSS 22.0软件将评估结果与临床手术进行逐一对照分析。结果26例患者Parks分型包括经括约肌型瘘17例、括约肌间型瘘7例和括约肌上型瘘2例,基于HR-MRI图像与三维可视化模型评价Parks分型准确性均为100%;26例患者共33个内口,基于HR-MRI图像评价内口优于三维可视化模型(P=0.180 vs P=0.022);15例患者共32个外口,基于三维可视化模型评价外口优于HR-MRI图像评价(P=0.791 vs P=0.049);20例患者伴肛周脓肿,基于HR-MRI图像与三维可视化模型评价均具有较高准确性(P=0.549 vs P=0.625);18例患者伴分支瘘管,基于三维可视化模型评价分支瘘管明显优于HR-MRI图像评价(P=1.000 vs P<0.001)。结论基于HR-MRI三维可视化模型对复杂性肛瘘Parks分型、外口、分支瘘管及脓肿的评价准确性较高,值得深入研究和推广。Objective To establish a three-dimensional visualization model of complex anal fistula based on high-resolution magnetic resonance imaging(HR-MRI),and to explore its feasibility and clinical application value.Methods The clinical and imaging data of 26 patients with complex anal fistula were analyzed retrospectively,and a three-dimensional visualization model based on HRMRI images was established.The Parks typing,internal orifice,external orifice,branch fistula and abscess were evaluated by radiologists and anorectal surgeons in HR-MRI images and the three-dimensional visualization model,and the SPSS 22.0 software was used to analyze the assessment results against the clinical surgery one by one.Results A total of 26 patients had 17 trans sphincteric fistulas,7 inter sphincteric fistulas,and 2 suprasphincteric fistulas,and the accuracy of Parks typing based on HR-MRI images and three-dimensional visualization model was 100%;26 patients had a total of 33 internal orifices,and the evaluation of internal orifices based on HR-MRI images was better than that of three-dimensional visualization model(P=0.180 vs P=0.022);15 patients had a total of 32 external orifices,and the evaluation of external orifices based on three-dimensional visualization model was better than that of HR-MRI images(P=0.791 vs P=0.049);20 patients had perianal abscesses,and the evaluations based on HR-MRI images and three-dimensional visualization model were both highly accurate(P=0.549 vs P=0.625);18 patients with branch fistula,the evaluation of branch fistula based on three-dimensional visualization model was significantly better than that of HR-MRI images(P=1.000 vs P<0.001).Conclusion Based on three-dimensional visualization model of HR-MRI,the evaluation of complex anal fistula Parks typing,external orifice,branch fistula and abscess is more accurate,which is worthy of further research and promotion.

关 键 词：三维可视化 高分辨率磁共振成像 肛瘘 

分 类 号：R445.2[医药卫生—影像医学与核医学] R657.16[医药卫生—诊断学]