肛瘘术前MRI征象与手术病理结果对照研究

Comparison of Preoperative MRI Features and Surgical-pathological Results in Perianal Fistula

目的探讨肛瘘术前MRI征象及其手术病理基础,以提高MRI对肛瘘的诊断水平。资料与方法分析经手术病理证实的28例肛瘘患者术前MRI征象,并与手术病理结果对照,比较不同手术病理结果与MR征象异同的相关性和MRI诊断的准确性。结果 MRI与手术病理结果比较,主瘘管(包括脓肿)正确显示率为100%,外口为100%,内口为87.1%(27个/31个),瘘管分支、多发细小瘘管为76.5%(13条/17条)。按照Parks分型,分型符合率为89.3%(25例/28例)。结论肛瘘的手术病理结果揭示了MRI征象的基础,MRI能准确地显示肛瘘的主瘘管(包括脓肿)、外口,比较准确地检测瘘管内口、瘘管分支、多发细小瘘管及肛瘘分型,对肛瘘的治疗方案及术式的选择具有重要价值。

Purpose To explore the preoperative MRI features and surgical-pathologic findings of perianal fistula and to improve MRI diagnosis.Materials and Methods In 28 patients with pathology proven perianal fistula,the preoperative MRI features and surgical-pathologic results were compared.Results The accuracy of MRI was 100% for primary tracts（including abscesses）;100% for external openings,87.1%（27/31）for internal openings,76.5%（13/17） for secondary and multiple small tracts.In 89.3%（25/28） of the cases,the MRI types were consistent with the Parks type.Conclusion MRI can accurately demonstrate the primary tracts（including abscesses） and external openings of perianal fistula and is valuable in treatment and surgery planning.。