高场磁共振在肛瘘诊治中的应用价值

Value of high-field MRI in diagnosis of anal fistula

目的探讨高场磁共振成像(MRI)在肛瘘诊断中的临床应用。方法 35例肛瘘患者行盆腔MR平扫检查,扫描序列包括轴位T1WI、T2WI及12WI脂肪抑制序列,矢状面及冠状面T2WI抑脂序列。分析肛瘘的MRI表现,评价瘘管与内外括约肌的关系,比较内、外口的显示率,并将诊断结果与手术进行对照。结果 33例肛瘘MR检查结果与手术结果一致;T2WI及V2WI脂肪抑制序列图像上,瘘管及肛周脓肿表现为高信号,于T1WI表现为条状略低信号,以抑脂像病灶显示最佳;脓肿在DWI上呈高信号。瘘口及瘘管MRI与手术符合率分别为94.9%及92.5%。结论应用高场MRI能准确定位肛瘘的内口、瘘管的走向及其与肛管直肠括约肌之间的关系,具有重要的临床实用和推广价值。

Objective To study the clinical application of high-field of MRI to the diagnosis of anal fistu_las. Methods 35 cases with anal fistulas were accepted MR scanning of pelvic without contrast, Scanning se_quences including TlWl、T2WI and T2WI fatsat in the transverse plane,T2WI fatsat in the sagittal plane and the coronal plane. The imaging of the anal fistulas was analyzed. Evaluate the relationship between internal and external sphincter fistula. The types and the display of the internal and external openings were assessed and the diagnosis with the operation results was compared. Results 33 cases of anal fistulas surgery MR ima_ging results are consistent with the operation results. Fistula showed low signal in T1WI and high signal in T2WI or T2WI fatsat, Abscess showed high signal on DWI;MRI with orificium and fistula coincidence rate with surgery were 94. 9% and 92. 5% respectively. Conclusion High-field MRI can locate the internal o_pening of anal fistula, form of anal fistula, and the relation of anal fistula with sphincter, which has impor_tant clinical practical and promotional value.