MRI在肛瘘疾病的术前诊断及评估

Preoperative Diagnosis and Evaluation of MRI in Anal Fistula

目的探讨MRI对肛瘘的术前诊断价值。方法收集2017年3月~2018年10月我院收治的肛瘘患者60例,常规进行盆腔MRI检查后2周内行手术切除,分析术前MRI显示肛瘘瘘管、外口、内口和肛提肌受累情况,以手术所见为标准,分析MRI对肛瘘显示准确率。结果术前MRI显示肛瘘瘘管、外口及内口、肛提肌受累与手术结果比较,差异无统计学意义(P>0.05)。瘘管在MRI表现为T1WI低信号,T2WI压脂序列为高信号,DWI序列为高信号;内口T2WI压脂序列为点状高信号;外口T1WI压脂序列为低信号,T2WI压脂序列为高信号。结论MRI对肛瘘瘘管、内口、外口及肛瘘累及范围显示均较佳,在肛瘘术前诊断及评估中具有较大的价值。

Objective To investigate the value of MRI in preoperative diagnosis of anal fistula. Methods 60 patients with anal fistula admitted to our hospital from March 2017 to October 2018 were enrolled. The patients underwent routine pelvic MRI examination within 2 weeks. The preoperative MRI showed anal fistula, external orifice, internal orifice and levator ani muscle involvement. In the case, the accuracy of MRI on anal fistula was analyzed by the standard of surgery. Results Preoperative MRI showed that the anal fistula, external and internal orifice, and levator ani muscle involvement were compared with the surgical results,the difference was not statistically significant (P>0.05). The MRI showed a low signal at T1WI, a high signal at T2WI, and a high signal at DWI. The T2WI pressure-lowering sequence was a point-like high signal;the T1WI pressure-lowering sequence was a low signal, and the T2WI pressure-lowering sequence was High signal. Conclusion MRI has a good indication of the extent of anal fistula, internal orifice, external orifice and anal fistula. It has great value in preoperative diagnosis and evaluation of anal fistula.