螺旋CT容积重建技术在高位复杂性肛瘘瘘管造影中的应用

Value of spiral CT volume reconstruction technique in high complex anal fistula fistulography

目的探讨螺旋CT容积重建（VR）技术在高位复杂性肛瘘瘘管造影中的应用价值。方法对35例手术证实并随访3个月以上无复发的高位复杂性肛瘘患者的螺旋CT瘘管造影资料，用VR技术对内口及支管情况进行回顾性分析，并与手术及随访结果对照。结果35例高位复杂性肛瘘中，VR图像上内口评价的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为72．7％、100％、74．3％、100％和18．1％，支管分别为93．8％、100％、94．6％、100％和72．7％。结论VR技术能三维再现瘘管的形态和走行特点，对内口及支管的诊断可靠，在高位复杂性肛瘘瘘管造影的分析中具有较高的应用价值。

Objective To evaluate the value of spiral CT volume reconstruction （VR） technique in high complex anal fistula fistulography. Methods To analyze retrospectively internal openings and secondary tracts of 35 cases with high complex anal fistula verified by operation and follow-up above 3 months with VR, and compared with operation and outcome of follow-up. Results In 35 cases with high complex anal fistula, for detection of the presence of internal openings, VR has a sensitivity of 72.7%, a specificity of 100% , a accuracy of 74.3 %, a positive predictive value of 100%, and a negative predictive value of 18.1%. Secondary tracts have a sensitivity of 93.8%, a specificity of 100.0% ,a accuracy of 94.6% ,a positive predictive value of 100.0% ,and a negative predictive value of 72.7%. Conclusion VR can demonstrate the 3D shape of fistula and is reliable in the diagnosis of internal openings and secondary ducts, and is very valuable in the analysis of high complex anal fistula fistulography.