磁共振平扫联合弥散加权成像对肛瘘的诊断价值  

Diagnostic Value of Magnetic Resonance Plain Scan Combined with Diffusion-weighted Imaging in Anal Fistula

作　　者：王鼎 伏云 张玲娟 黄丽静 陆琪 Wang Ding;Fu Yun;Zhang Lingjuan;Huang Lijing;Lu Qi(Wujiang District Hospital of Traditional Chinese Medicine(The Second People's Hospital of Wujiang District),Suzhou,Jiangsu 215221)

机构地区：[1]苏州市吴江区中医医院(吴江区第二人民医院),江苏苏州215221

出　　处：《现代医用影像学》2024年第5期854-857,共4页Modern Medical Imageology

摘　　要：目的:探讨磁共振平扫联合弥散加权成像对肛瘘的诊断价值。方法:选取2020年1月至2023年8月在苏州吴江区中医院就诊疑似肛瘘患者30例,均行磁共振平扫联合弥散加权成像扫描,以临床及手术综合诊断结果作为金标准,分析比较磁共振平扫和磁共振平扫联合弥散加权成像两种检查方法对肛瘘的诊断结果。结果:经临床及手术综合诊断有肛瘘患者15例(阳性组),无肛瘘患者15例(阴性组)。磁共振平扫在阳性组诊断正确9例,在阴性组诊断正确12例,准确率为70.0%,漏诊率40.0%,误诊率20.0%;磁共振平扫联合弥散加权成像在阳性组诊断正确13例,在阴性组诊断正确15例,准确率为93.3%,漏诊率13.3%,误诊率0.0%;相比较两种检查方法的准确率、误诊率及漏诊率均有统计学差异(P<0.05)。另外,磁共振平扫联合弥散加权成像对内口、瘘管、肛周脓肿检出率均显著高于单一的磁共振平扫检查,差异具有统计学意义(P<0.05)。结论:磁共振平扫联合弥散加权成像检查对肛瘘的检出及瘘口、脓肿的评估优于单一的磁共振平扫,可避免漏诊及误诊的发生,值得临床推广应用。Objective:To explorethediagnostic valueof MR plain scan combined withdiffusion-weighted imaging in anal fistula.Methods:From January 2020 to August 2023,30 patients with suspected anal fistula were selected from Wujiang District Hospital of Traditional Chinese Medicine,Suzhou,and all of them underwent MR plain scan combined with dffusion-weighted imaging scanning.Taking the clinical and surgical comprehensive diagnosis results as the gold standard,the diagnostic results of MR plain scan and MR plain scan combined with diffusion-weighted imaging were analyzed and compared.Results:15 patients with anal fistula(positive group)and 15 patients without anal fistula(negative group)were diagnosed by clinical and surgical comprehensive diagnosis.MRI plain scan correctly diagnosed 9 cases in the positive group and 12 cases in the negative group,with an accuracy rate of 70.0%,a missed diagnosis rate of 40.0%and a misdiagnosis rate of 20.0%.MR plain scan combined with difusion-weighted imaging corectly diagnosed 13 cases in the positive group and 15 cases in the negative group,with an accuracy rate of 93.3%,a missed diagnosis rate of 13.3%and a misdiagnosis rate of 0.0%.The accuracy,misdiagnosis rate and missed diagnosis rate of the two methods were statistically different(P<0.05).In addition,the detection rate of internal orifice,fistula and perianal abscess by MR plain scan combined with diffusion-weighted imaging was significantly higher than that by single MR plain scan,with statistical significance(P<0.05).Conclusion:MR plain scan combined with diffusion-weighted imaging is superior to single MR plain scan in detecting anal fistula and evaluating fistula and abscess,which can avoid missed diagnosis and misdiagnosis,and is worthy of clinical application.

关 键 词：磁共振平扫 弥散加权成像 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]