直肠阴道瘘的MRI表现

MRI features of rectovaginal fistula

目的:探讨直肠阴道瘘(RVF)的MRI成像特点。方法:回顾性分析经临床确诊的16例RVF患者的MRI资料。结果:16例中,直肠癌术后6例、宫颈癌根治术及放疗后4例、产伤5例、先天性巨结肠术后损伤1例。其中低位瘘6例,中位瘘5例,高位瘘5例;瘘口直径>2.5 cm 2例,1.0~2.5 cm 3例,0.5~1.0 cm 9例,<0.5 cm 2例;T1WI呈低信号;T2WI、STIR呈粗细不等的线状或管状低、高或高低信号影,沟通直肠前壁与阴道后壁;DWI呈低、高或高低信号。结论:MRI可清楚显示RVF瘘口位置、大小、分型及瘘管走行,并可显示肛周肌群的情况,为临床手术个体化方案的制订提供可靠依据。

Objective:To investigate the application value of MRI in rectovaginal fistula(RVF).Methods:The data of MRI of 16 patients with RVF confirmed clinically in our hospital were retrospectively analyzed.Results:There were 6 cases of low fistula,5 cases of median fistula and 5 cases of high fistula.The size of fistula:> 2.5 cm 2 cases,1.0~2.5 cm 3 cases,0.5~1.0 cm9 cases,<0.5 cm 2 cases.In the sequence of T1WI,the fistulas were low signal,in the sequences of T2WI and STIR the fistulas presented as low signal,high signal,or low signal accompanied with high signal of linear or tubular varying in thickness that communicated the anterior rectal wall and posterior vaginal wall.DWI were low signal or high signal,or low signal accompanied with high signal.Conclusions:The location,size,classification and course of RVF fistula can be clearly demonstrated by MRI,it can also show the condition of perianal muscles,all that can provide a reliable basis for the formulation of individualized clinical operation program.