高分辨率MRI在复杂性肛瘘诊断中的价值研究

The value of high-resolution MRI in the diagnosis of perianal fistula

目的:探讨复杂性肛瘘的MRI表现及其临床诊断价值。方法:48例可疑复杂性肛瘘患者,行盆腔MR平扫检查,扫描序列包括横断面FSE-T1WI、T2WI、T2WI抑脂及STIR扫描,矢状面STIR及T2WI扫描,冠状面STIR及T2WI抑脂扫描。分析肛瘘的MRI表现,评价瘘管与内外括约肌的关系及复杂性肛瘘的分型,比较内、外口的显示率,将诊断结果与手术进行对照。结果:瘘管于T1WI表现为条状略低信号,T2WI、T2WI抑脂及STIR序列呈明显高信号,以抑脂像病灶显示最佳。MR诊断与手术比较符合率分别为:肛瘘(或脓肿)96.9%,内口82.4%,外口100%,分型86.7%。结论:MRI是复杂性肛瘘的一种重要诊断方法,具有重要的临床价值。

Objective：To study the MR imaging of complex perianal fistulas and its diagnosis valuation.Methods：48 patients suspected of complex perianal fistulas were accepted MR scanning of pelvic without contrast,scanning sequences,including FSE-T1WI,T2WI,T2WI-fatsat and STIR in the transverse plane,STIR and T2WI in the sagittal plane,STIR and T2WI-fatsat in the coronal plane.The imaging of the complex perianal fistulas was analyzed.The relations among the fistula and internal and external anal sphincter,the types and the display of the internal and external openings were assessed,and the diagnosis with the operation results was compared.Results：Fistula showed low signal in T1WI and high signal in T2WI, T2WI-fatsat and STIR;it was more distinct on fatsat sequences.Compared with the operation results,the correct rate of MRI diagnosis was 96.9%（fistulas or abscesses）,82.4%（internal openings）,100%（external openings）,86.7%（types）,respectively.Conclusion：MRI is an important diagnostic method for complex perianal fistula,and has great value.