肛瘘术前评估新方法:多层螺旋CT直肠填塞瘘管造影三维重组技术临床应用探讨

The Three-dimensional Reconstruction of Multi Slice Spiral CT Fistulography in Preoperative Assessment of Fistula in Anal Fistula

目的探讨多层螺旋CT(MSCT)直肠填塞瘘管造影三维重组技术及临床应用价值。资料与方法通过MSCT直肠填塞瘘管造影三维重组技术对31例临床拟诊或确诊肛瘘的患者行前瞻性研究,将结果与手术或临床结论对照。结果31例中27例为复杂性肛瘘,4例为单纯性肛瘘。对肛瘘内口诊断(截石点位及距肛门距离)的准确性、敏感性、特异性分别为93.9%、96.7%、66.7%。结论MSCT直肠填塞瘘管造影三维重组技术是肛瘘术前评估的一种新方法,能准确显示瘘管内口截石点位、定量诊断内口距肛门距离,多平面显示瘘管的性状及其与周围组织的关系,有较高的临床应用价值。

Objective To evaluate the value of three dimensional reconstruction of Mscr fistulography in anal fistula. Materials and Methods Ethical committee approval and informed consent were obtained. A total of 31 patients who were suspected of having anal fistula had preoperative the fistulography of MSCT. The CT data were transferred to a workstation for three dimensional reconstruction. The three dimensional reconstruction images were generated from the workstation. The findings were compared with the operation. Results Complex fistulas were found in 27 of 31 patients and 4 patients had simple intersphincteric fistula. The accuracy,sensitivity and specificity for the detection of the inner orificium with MSCT Fistulography were 93.9%, 96.7%, 66.7%. Conclusion The three dimensional reconstruction of Mscr fistulography is valuable for preoperative assessment the correlation between anal fistula and anal sphincter and reveal accurately the inner orificium.