MRI不同序列成像在肛周脓肿的诊断和分型中的应用

To evaluate the contribution of various magnetic resonance imaging sequences in determining the type of perianal obsess

目的探讨MRI轴位、冠状位及矢状位T1WI压脂(FS)增强序列在肛周脓肿诊断和分型中的应用价值。方法经手术证实的30例脓肿患者全部进行T1WI-FS增强MRI扫描,以手术结果为对照标准,统计分析增强MRI扫描序列组合对各种类型肛周脓肿及内口的检出率。结果 30例病人MRI显示肛周脓肿52个,轴位和冠状位T1WI-FS增强序列,对于坐骨肛管间隙脓肿显示率均为100%。前者对于诊断位于肛提肌下方的脓肿和内口准确率高,均为100%。后者对于诊断肛提肌上方的脓肿准确率高,均为100%。结论理想的肛周脓肿的检查方法是轴位联合冠状位FS-T1WI增强序列,可为外科手术方式的选择提供可信的影像资料。

Objective The aim of our study was to assess the contribution of the axial, coronal and sagittal enhanced MRI with Gd - DTPA sequences in determining the type of perianal obsess. Methods 30 patients with surgically proved pefi- anal obsess underwent enhanced imaging with Gd - DTPA. The numbers of MR/findings were compared with the sur- gical results. Results 30 patients were found to have 52 perianal obsess, Tile CE - AX - T1 - FS sequences and the CE - COR - T1 - FS had the highest accuracy of chiorectal abscesses （ 100% ）. The former sequences had the highest accuracy of abscess on the levator ani （ 100% ）. The CE - COR - T1 - FS sequences had the highest accuracy of abscess under the levator ani （ 100% ）. The CE - AX - T1 - FS sequences had the highest accuracy of all internal openings （ 100% ）. Conclusion Ideal combination of MRI sequences for perianal obsess combining were combining CE - AX - TI - FS and CE - COR - T1 - FS sequences. They was sufficient to make an assessment before deciding the surgical extent of the procedure.