复杂性肛瘘的MRI诊断价值

Usefulness of Magnetic Resonance Imaging with Phased Array Coils for Diagnosing Complex Fistula-in-ano

目的探讨复杂性肛瘘MRI检查的应用价值。方法应用相控阵线圈,对95例临床诊断为复杂性肛瘘的患者,术前进行MRI检查,其中60例直肠腔内放置水囊,35例直肠处于正常闭合状态。检查结果与术后结果进行比较。结果在95例肛瘘中,Park's分类显示:经括约肌肛瘘17例,括约肌间肛瘘50例,括约肌外肛瘘13例,括约肌上肛瘘15例。该结果与术后结果一致。MRI对内口检出符合率为90.52%;原发主管、支管/脓腔检出准确率为94.7%和96.8%。结论应用相控阵线圈的MRI检查方法,能准确定位复杂性肛瘘的内口、瘘管的走向及其与肛管直肠括约肌复合体之间的复杂关系。如结合直肠腔内放置水囊检查,有利于显示病灶周围组织结构和提高影像学对比度。

Objective To prospectively evaluate the usefulness of magnetic resonance imaging（MRI）with phased array coils for the diagnosis of complex fistula-in-ano.Methods A total of 95 patients with clinically suspected complex fistula-in-ano underwent preoperative digital examination and MRI with phased array coils.Outcomes of MRI and the surgical findings were compared.Results The types of track in patients with a complex fistula were trans-sphincteric（n=17）,intersphincteric（n=50）,supra-sphincteric（n=15） and extra-sphincteric（n=13）.Sensitivity of internal opening with MRI was 90.52%,and that of primary tract and secondary extension were 94.7%and 96.8%.Conclusions MRI with hyponome in rectum and phased array coils can correctly orient the internal opening,trend of the complex fistula-in-ano and the complicated relationship of anorectal sphincters.Hyponome in rectum helps to show the institutional framework around the focus and improve the image to study contrast ratio.