复杂性肛瘘手术采用核磁共振技术诊断对于临床效果的价值

Clinical Effects of Magnetic Resonance Imaging Technique Diagnosis in Complex Anal Fistula Operation

目的：探究并分析核磁共振技术诊断复杂性肛瘘手术的临床效果。材料与方法：回顾性分析自2010年1月～2013年3月我院肛肠科收治的经手术探查确诊为复杂性肛瘘的50例患者，所有患者术前均进行核磁共振技术（MRI）扫描及一般检查，以手术结果为标准。将MRI检查及术前一般检查结果进行比较。结果：术前MRI检测结果为4例为单纯性肛瘘且均为肛管括约肌间瘘，46例为复杂性肛瘘（其中37例为经肛管括约肌瘘，7例高位肛瘘，2例肛瘘术后改变且合并骶前脓肿及合并盆腔内多发脓肿）。与手术探查的结果相比，MRI诊断对复杂性肛瘘的诊断准确率为92．00％，术前一般检查的诊断准确率为56．00％，术前MRI诊断准确率与手术探查较为接近，而术前一般检查的诊断准确则较术前MRI扫描低，P〈0．05，具有统计学意义；术前MRI扫描在肛瘘内口、肛瘘主管、肛瘘支管及脓腔方面的诊断准确率分别为72．00％、100．00％、92．00％，术前一般检查的诊断准确率分别为64．00％、60．00％、58．00％，术前一般检查及MRI扫描在肛瘘内口位置的诊断准确率较为相近，无明显差异（P〉0．05）；而在肛瘘主管、肛瘘支管及脓腔诊断准确率方面，术前MRI扫描的诊断准确率明显高于术前一般检查，P〈0．05，具有统计学意义。结论：对提高手术的成功率及避免过多的肛门括约肌损伤具有重要指导意义，值得在临床上广泛应用。

Purpose： To explore and analyze the NMR diagnostic complex anal fistula surgery clinical results. Mate- rials and Methods： Since January 2010 - January 2013 anorectal hospital treated 50 patients with complex anal fistula pa- tients, all patients underwent preoperative magnetic resonance techniques （ MRI ） scans and general examination to surgical findings as the standard, the MRI examination and preoperative general examination results were compared. Results： Preop- erative MRI test results for the four cases of anal fistula and anal sphincter are among fistula, 46 cases of complex anal fistula （ including 37 cases of fistula through the anal sphincter, seven cases of high anal fistula, two cases of anal fistula and postop- erative changes consolidation and mergers presacral abscess muhiple pelvic abscess）. Compared with the results of surgical ex- ploration, MRI diagnosis of complex anal fistula diagnostic accuracy was 92. 00% , general inspection of preoperative diagnos- tic accuracy was 56. 00% , the diagnostic accuracy of preoperative MRI and surgical exploration is closer, and preoperative general the diagnostic accuracy compared preoperative MRI scan low, p 〈 0. 05, statistically significant ; preoperative MRI scans fistula inside the mouth, anal fistula supervisor, anal fistula manifold and abscess aspects diagnostic accuracy rates were 72. 00% , 100. 00% , 92.00% , preoperative general inspection of the diagnostic accuracy rates were 64. 00%, 60. 00%, 58.00% , preoperative general examination and MRI scans fistula inside the mouth position the diagnostic accuracy is more similar, no significant difference （ p 〉 0. 05 ） ; while in charge of anal fistula, anal fistula and abscess manifold diagnostic ac- curacy rate of preoperative diagnostic accuracy of MRI scan before surgery was significantly higher than the general inspection, P 〈 0. 05, statistically significant. Conclusion ： to improve the success rate of surgery and avoid excessive anal sphincter in- jury of important guiding significance, worthy of wide application in clinical practice.