磁共振成像在复杂性肛瘘诊疗中的应用研究进展  

Research progress of magnetic resonance imaging in the diagnosis and treatment of complex anal fistula

作　　者：黄捷敏 石荣[2] HUANG Jiemin;SHI Rong

机构地区：[1]福建中医药大学,福建福州350122 [2]福建中医药大学附属人民医院,福建福州350004

出　　处：《中医临床研究》2024年第36期113-117,共5页Clinical Journal Of Chinese Medicine

基　　金：陈民藩国医大师传承工作室建设项目(国中医药办人教函[2022]245号)。

摘　　要：复杂性肛瘘是肛肠疾病中较难治疗且发病率较高的一类,涉及病变部位广泛,诊疗困难,术后易复发,切口难以恢复,易出现后遗症,对患者生活质量造成严重影响。复杂性肛瘘的治疗以手术为主,而手术的关键点是保护肛门功能,减少对括约肌的损伤,而随着现代医学技术不断创新和发展,提高治疗肛瘘的成功率也受到临床的广泛关注。术前运用磁共振成像技术(Magnetic Resonance Imaging,MRI)等现代医学技术正确分析瘘道位置深浅、走行方向、病变情况及明确瘘道与括约肌间的关系,是手术疗效良好的基本保证。目前,MRI主要有MRI常规序列诊断、磁共振弥散加权成像(Diffusion Weighted Imaging,DWI)、钆剂瘘道造影联合动态增强磁共振成像(Dynamic Contrast Enhanced-MRI,DCE-MRI)、3D-Slicer软件技术和LAVA序列增强MRI等。MRI对瘘道周围软组织分辨率高、多层面成像,可清晰显示细小瘘道分支和瘘道内口,为复杂性肛瘘手术提供瘘道与肛门括约肌之间精确的解剖位置和关系,还能呈现瘘道与肛门括约肌、肛提肌、盆底肌之间的解剖信息的综合影像学图像,这有利于复杂性肛瘘术前方案的确定和术中病灶完全清理,可降低术后并发症的发生和复发率。各类MRI在复杂性肛瘘诊疗中的侧重点不同,为更好地在临床中应用磁共振成像技术,研究对MRI在复杂性肛瘘诊疗方面的应用研究进展进行总结分析。Complex anal fistula is a kind of anorectal diseases that is difficult to treat and has a high incidence.It involves a wide range of lesion sites,complicated course,difficult diagnosis and treatment,and postoperative fistula is prone to recurrence,incision is difficult to recover,and sequelae are prone to occur,which seriously affects the quality of life of patients.The treatment of complex anal fistula is mainly surgical,and the key point of surgery is to protect the anal function and reduce the damage to the sphincter muscle.With the continuous innovation and development of modern medical technology,besides not damaging the anal function,improving the success rate of treating anal fistula to the greatest extent has also received extensive attention from anorectal surgeons.The use of magnetic resonance imaging(MRI)and other modern medical technology before surgery to correctly analyze the depth of the fistula,the direction of shape,the lesions and the relationship between the fistula and the sphincter is the basic guarantee of good surgical effect.At present,magnetic resonance imaging(MRI)mainly includes routine MRI sequence diagnosis,magnetic resonance diffusion-weighted imaging(MRI-DWI),gadolinium fistula angiography combined with dynamic enhanced magnetic resonance imaging(DCE-MRI),3D-Slicer software technology,LAVA sequence enhanced MRI,etc.Magnetic resonance imaging(MRI)can provide high-resolution and multi-dimensional imaging of the soft tissues around the fistula,which can clearly show the branches of the small fistula and the internal opening of the fistula,and provide accurate anatomical location and relationship between the fistula and the anal sphincter for complex anal fistula surgery.In addition,it can also present comprehensive imaging images of the anatomical information between the fistula and the anal sphincter,anal levator and pelvic floor muscle.This is conducive to the determination of the preoperative program of complex anal fistula,the complete cleaning of the lesions during the operation,a

关 键 词：复杂性肛瘘 磁共振成像技术 临床诊疗 

分 类 号：R657.16[医药卫生—外科学]