磁共振成像检查对肛提肌脓肿的定位诊断及价值

Location diagnosis and value of MRI examination for levator ani abscess

目的探讨磁共振成像(MRI)检查对肛周感染继发肛提肌脓肿影像表现的认识、定位及诊断价值。方法回顾性研究具有完整手术记录、病理资料及MRI资料的直肠肛管周围感染及继发于肛提肌脓肿的肛瘘病例15例,分析MRI检查对寻找瘘管、肛瘘分型、判断肛提肌感染路径的价值。结果 15例肛提肌脓肿患者中括约肌上型肛瘘8例,经括约肌型肛瘘4例,括约肌间型肛瘘2例,括约肌外型肛瘘1例。15例患者中脓肿经括约肌间隙内向上蔓延9例,经坐骨肛管窝瘘管向上蔓延累及肛提肌4例,经肛管后间隙向上蔓延1例,癌性瘘管1例。结论 MRI检查对肛提肌脓肿感染源头及路径的确定具有很大优势,对临床手术具有重要指导意义。

Objective To explore the understanding, location and diagnostic value of MRI examination on the imaging manifestations of secondary anal abscess secondary to perianal infection. Methods Fifteen cases of anorectal infection and anal fistula secondary to anal abscess with complete operation, pathology and MRI data were retrospec-tive studied. Analysis the value of MRI for searching the anal fistula, detecting the type of the anal fistula and find-ing the infection route of levator ani muscle. Results Among the 15 cases, 8 cases were suprasphincteric fistula, 4 cases were transsphincteric fistula, two cases were intersphincteric fistula, ong cases were extrasphincteric fistula. Of the 15 cases, 9 cases the abscess spreaded up through the sphincter space, four cases spreaded up through the sciatic rectal fossa fistula and involved the levator ani muscle, 1 case spreaded through the posterior anal canal space, 1 case spreaded through the carcinomatous fistula. Conclusion MRI examination has a big advantage of detecting the accurate location and route of infection of levator ani muscle abscess, and is of great significance in guiding the clin-ical operations.