高分辨率磁共振成像检查在肛瘘中的诊断价值  

The Diagnostic Value of High-resolution Magnetic Resonance Imaging in Anal Fistulas

作　　者：陈华[1] 李慧[1] 张继 张波[1] CHEN Hua;LI Hui;ZHANG Ji;ZHANG Bo(The Affiliated Taizhou People’s Hospital of Nanjing Medical University,Taizhou Jiangsu 225300,China)

机构地区：[1]南京医科大学附属泰州人民医院,江苏泰州225300

出　　处：《泰州职业技术学院学报》2025年第2期73-75,89,共4页Journal of Taizhou Polytechnic College

摘　　要：目的本研究旨在深入探讨高分辨率MRI在肛瘘诊断中的应用价值。方法采用西门子MAGNETOM Skyra 3.0T成像仪,对70例病例行矢状面、斜冠状面及斜横断面的T2WI与T2WI脂肪抑制序列,斜横断面T1WI,并附加DWI序列,扫描流程始于矢状位T2WI-FS以确定肛管位置与病灶概况,随后依肛管长轴方向进行斜冠状位与斜轴位扫描。结果70例肛瘘病例中,包含高位20例(复杂12例,单纯8例)与低位50例(复杂28例,单纯22例)。所有病例均见内外括约肌受累,以外括约肌为主。病例分类:28例单内口单瘘管,24例单内口多瘘管伴一外口,7例多内口多外口多瘘管,另有11例并发肛周脓肿。70例患者中,肛瘘分级如下:I级13例,II级11例,III级16例,IV级最多,达20例,V级4例,VI级6例。结论对肛瘘患者展开高分辨率磁共振成像检查可以提供清晰、详细的图像信息,帮助医生准确判断肛瘘的类型、瘘管的走行和分支情况以及括约肌的损伤情况。Objective This study aims to further explore the application value of high-resolution MRI in the diagnosis of anal fistula.Methods A total of 70 patients with anal fistulas underwent MRI examinations using a Siemens MAGNETOM Skyra 3.0T scanner.The imaging protocol included sagittal,oblique coronal,and oblique axial T2-weighted imaging(T2WI)and fat-suppressed T2-weighted imaging,oblique axial T1-weighted imaging(T1WI),and diffusion-weighted imaging(DWI).The scanning protocol began with sagittal T2WI-FS to localize the anal canal and assess lesion overview,followed by oblique coronal and oblique axial scans aligned with the long axis of the anal canal.Results Among the 70 cases,20 were classified as high-level fistulas(12 complex,8 simple)and 50 as low-level fistulas(28 complex,22 simple).All cases exhibited involvement of the internal and external sphincters,predominantly the external sphincter.Case classifications included:28 cases with a single internal opening and single fistula tract,24 cases with a single internal opening and multiple fistula tracts(with one external opening),7 cases with multiple internal/external openings and complex fistula tracts,and 11 cases complicated by perianal abscesses.The fistula grading was as follows:Grade I(13 cases,18.57%),Grade II(11 cases,15.71%),Grade III(16 cases,22.86%),Grade IV(20 cases,28.57%),Grade V(4 cases,5.71%),and Grade VI(6 cases,8.57%).Conclusion High-resolution MRI provides clear and detailed imaging information for anal fistula diagnosis,enabling accurate assessment of fistula type,tract course,branching patterns,and sphincter involvement.

关 键 词：肛瘘 高分辨率磁共振成像 多序列成像 

分 类 号：R657.16[医药卫生—外科学] R445.2[医药卫生—临床医学]