核磁共振成像对术后肛周深部感染性病变的临床诊断价值研究

Clinical value of magnetic resonance imaging in diagnosis of postoperative deep anorectal infection

目的探讨核磁共振成像技术(MRI)诊断术后肛周深部感染性病变的临床价值,为术后肛周深部感染性病变的诊断提供参考。方法选取2015年1月-12月医院诊治的拟诊为术后肛周脓肿的患者60例,行MRI检查,与手术结果进行比较。结果 60例术后肛周深部感染性疾病,56例为单纯肛周深部脓肿,4例为肛周深部脓肿合并瘘管,共有68个脓腔,60个内口,其中脓腔32个在坐骨直肠间隙、24个在骨盆直肠间隙、12个在高位括约肌间,分别占47.06%、35.29%、17.65%,脓腔形态31个为不规则条块、20个为类圆形、17个为分叶状,构成比分别为45.59%、29.41%、25.00%,54例为单房、6例为多房脓肿,构成比分别为90.00%、10.00%;MRI诊断出56例为单纯肛周深部脓肿,4例为肛周深部脓肿合并瘘管,诊断准确率为100.00%,诊断出65个脓腔,53个内口,坐骨直肠间隙、骨盆直肠间隙、高位括约肌间脓腔诊断准确率分别为100.00%、91.67%、91.67%,与手术确诊比较差异无统计学意义,内口诊断准确性为88.33%低于手术确诊,差异有统计学意义(P<0.05)。结论 MRI诊断术后肛周深部感染性病变准确率高,清晰显示脓肿及内口所在位置及脓腔数目、瘘管走形等特征,可为病情诊断及手术提供重要指导信息。

OBJECTIVE To explore the clinical value of magnetic resonance imaging（MRI）in diagnosis of postoper-ative deep anorectal infection so as to provide guidance for diagnosis of the postoperative deep anorectal lesions. METHODS A total of 60 patients with postoperative anorectal abscess who were treated in hospitals from Jan 2015 to Dec 2015 were enrolled in the study,all of the patients received the MRI,and the MRI results were compared with the surgical results.RESULTS Among the 60 patients with postoperative deep anorectal infectious diseases, there were 56 cases of simple deep anorectal abscess and 4 cases of deep anorectal abscess complicated with fistula. There were totally 68 vomicae and 60 endostoma,including 32（47.06%）vomicae in sciatic rectum gap,24 （35.29%）vomicae in pelvis rectum clearance and 12（17.65%）vomicae between high sphincter.There were 31 （45.59%）cases of irregular market of pus cavity forms,20（29.41%）cases of circular forms and 17（25.00%） cases of lobulated form.There were 54（90.00%）cases of single room abscess and 6（10.00%）cases of multi-room abscess.The result of MRI showed that 56 cases were diagnosed with simple deep anorectal abscess,and 4 cases were diagnosed with deep crissum abscess complicated with fistula,with the accurate rate of diagnosis 100.00%;totally 65 cases of vomica and 53 cases of endostoma were diagnosed,the accurate rates of diagnosis of vomicae in sciatic rectum gap,pelvis rectum clearance and high sphincter abscess cavity were 100.00%,91.67%and 91.67%,respectively,as compared with the surgical diagnosis,there was no significant difference;the accu-racy of diagnosis of endostoma was 88.33%,significantly lower than that of the surgical diagnosis（P〈 0.05）. CONCLUSION The accurate rate of MRI is high in diagnosis of the postoperative deep anorectal infections,it can clearly display the location of abscess,number of abscess cavity and fistula contorts,which may provide guidance for diagnosis of illness conditio and surgery.