肛门直肠畸形的多层螺旋CT的诊断价值

The diagnostic value of multi-slice CT on anorectal malformation

目的探讨多层螺旋CT(MSCT)在肛门直肠畸形诊断中的价值。方法收集手术证实的26例肛门直肠畸形,每例患儿术前均做了多层螺旋CT检查。结果 8例手术证实为高位肛门闭锁,直肠末端位于PC线以上,直肠末端与肛门窝皮肤之间的距离大于25mm。2例有骶椎或尾椎畸形,1例患有肾结石。3例患有直肠阴道瘘、1例患有直肠尿道瘘。4例肛门括约肌不对称。4例证实为中间位肛门闭锁,直肠末端与PC线平齐,直肠末端与肛门窝皮肤之间的距离约16mm。1例患有直肠尿道瘘。1例肛门括约肌不对称。14例证实为低位肛门闭锁,直肠末端位于PC线以下,直肠末端与肛门窝皮肤之间的距离小于10mm。3例患儿发现有会阴瘘,其中2例显示清楚。13例肛门括约肌正常,1例稍有不对称。结论手术前多层螺旋CT可以直接显示直肠末端的位置及大多数并发畸形,因此可以用于肛门直肠畸形术前手术方式的选择及预后的判断。

Objective To study the value of multi-slice CT（MSCT） on anorectal malformation.Methods Twenty six cases with operatively proved anorectal malformation were collected.Multislice CT Imaging was performed in all patients.Results High loction imperforate anus were demonstrated in 8 cases,the rectal end of them were above PC line,and the distance between the rectal end and anal skin pouch was more than 25 mm.Two cases of the malformation with vertebrae sacrales and caudal vertebrae,and 1 case together with the stone of kidney,3 cases of the rectovagina fistula and 1 case of rectourethral fistula were found.The sphincter of anus was asymmetry in the 4 cases.Four casese were proved of middle location of imperforate anus.The rectal end was equal wth PC line,the distance between the rectal end and anal skin pouch was about 16 mm.One case was found the fistula between the urethra and the rectum.The sphincter of anus was asymmetry in the 1 case.Fourteen cases were confirmed of low location of imperforate anus.The rectal end was under PC line,the distance between the rectal end and anal skin pouch was less than 10 mm.Three cases of perineal fistula were found,two of them were displayed clearly.The sphincter of anus were normal in 13 cases.One case was found slightly asymmetry in low location imperforate anus.Conclusion Preoperative multi-slice CT can directly depict the location of the rectal end and the most combinations of malformations.Therefore,it could afford the witnesses for the choice of operative fashion and the forecast of the prognosis or complications.