MRI和DWI在肛瘘分级中的应用价值

MRI and DWI in Classification of Anal Fistula

为探讨磁共振成像（MRI）和弥散加权成像（DWI）在肛瘘分级中的应用价值，经手术证实的肛瘘患者20例，全部接受常规检查，增强MRI及DWI功能检查。根据评价检查出的瘘管、内口、外口，对肛瘘进行分级，并与手术结果相对照。结果显示，20例肛瘘患者中，1级2例（10％），2级3例（15％），3级2例（10％），4级9例（45％），5级4例（20％）。MRI诊断出瘘管25个，正确率为89．3％（25／zs）；诊断出内口19个，正确率为86．4％（19／22）；诊断出肛周脓肿15个，正确率为9g．8％（15／16）。MRI诊断出的内、外口位置。瘘管的走行及脓肿的范围与手术所见基本一致。结果表明，MRI和DWI可以获得更多有关瘘管及其走行的信息，有助于肛瘘的分级，有利于外科医师选择正确的治疗方法，并能预测预后。

This paper aimed to discuss clinical weighted imaging（DWI） in the classification of fistula received conventional and enhanced MRI value of magnetic resonance imaging（MRI） and diffusion anal fistula. Twenty surgically confirmed cases with anal check and DWI function examination. According to inspected fistula tract, internal opening, external opening were evaluatio,anal fistula was classified, the results of which were compared with operative findings. The results showed that of 20 cases with anal fistula, 2 were in grade I （10%）, 3 in grade II[（15%）, 2 in grade III （10%）, 9 in grade IV （45%）,4 in grade V （20~）. Anal fistula was diagnosed byMRIin 25 cases , with a correct rate of 89.3%（25/28）; internalopening in 19 cases,with a correct rate of 86.4%（19/21） ; perianal abscess in 15 cases,with a correct rate of 93.8%（15/16）. The location of internal opening, external opening, anal fistula trend and abscess range demonstrated by MRI were basically the same as operative findings. It is concluded that MRI and DWI can demonstrate more about fistula and trend, which contributes to its classification and is helpful for surgeons to select proper therapeutic methods and predict prognosis.