肛肠水囊填塞MR成像在肛瘘诊断中的价值

Value of MRI Padding with Ano-rectal Water Plug in Diagnosis of Anal Fistula

目的探讨高分辨MR成像中使用自制肛肠水囊在肛瘘诊断中的价值。方法比较水囊放置前后肛瘘病变的显示率、瘘管末端位置以及MRI分型的符合率。结果22例患者共有26个内口,22条主瘘管,16条支管,23个外口,8例伴肛周脓肿或感染。放置水囊前后MRI上内口的显示率分别为76.9%(20/26),69.2%(18/26),两者之间差异无统计学意义(χ2=0.74,P>0.05);主瘘管、支管及外口数与放置水囊前相同,分别为100%(22/22),100%(16/16),91.3%(21/23)。使用水囊前后,MRI对瘘管末端位置的判断差异具有统计学意义(χ2=6.85,P<0.05),MRI对肛瘘分级的符合率有统计学意义(χ2=4.82,P<0.05)。结论通过自制肛肠水囊的使用,能够更好地分辨瘘管末端位置,从而使肛瘘的分级更为准确。

Objective The study was designed to investigate the value of using a self- made ano-rectal water plug in diagnosis of anal fistula by high-resolution magnetic resonance imaging （MR1）. Methods The display rate of anal fistulas, the position of fistula end and the compliance rate of MRI classification were compared before and after placement of water plug. Results Among 22 patients, there were a total of 26 internal openings, 22 primary fistulas, 16 branches and 23 external openings, in which eight cases were accompanied with perianal abscesses or infections.In contrast with the operation, the display rates of internal openings by MRI were 76.9% （20/26） and 69.2% （18/26） before and after the placement of water plug, respectively, and the differences were not statistically significant between two groups （ X 2=0.74, P〉0.05）. The numbers of primary fistulas, branches and external openings were 100% （22/22）, 100% （16/16） and 91.3% （21/23）, respectively, which were the same as those before the placement of water plug.lt showed a statistically significant difference in determining the position of end of the fistula by MR before and after the use of water plug （X 2=6-85, P〈0.05）, and the compliance rates of anal fistula classification was statistically significant （ X 2=4.82, P〈0.05）. Conclusion The position of end of the fistula could be better distinguished by using a self-made ano- rectal water plug, thus promoting more accurate classification of anal fistulas.