MR高分辨率T2WI抑脂序列联合DWI及增强扫描对肛瘘诊断价值的探讨

Discussion on diagnostic value of high resolution MR T2WI fat suppression sequence combined with DWI and enhanced scanning in anal fistula

目的探究磁共振(MR)高分辨率T2加权成像抑脂(T2WIFS)序列联合弥散加权成像(DWI)及增强扫描对肛瘘诊断价值。方法40例疑似肛瘘患者,分别进行常规系列+高分辨率T2WIFS+DWI+增强的MR增强型检验和常规系列+高分辨率T2WIFS的MR常规型检验。比较两种检验方法的肛瘘分型检验结果。结果MR增强型检验内口、外口、瘘管、脓肿的检查正确率分别为93.75%、95.65%、92.00%、100.00%,均高于MR常规型检验的62.50%、65.21%、68.00%、70.58%,差异有统计学意义(P<0.05);MR增强型检验括约肌间型、经括约肌型、括约肌上型、括约肌外型的检查正确率分别为92.86%、83.30%、90.00%、100.00%,均高于MR常规型检验的57.14%、75.00%、40.00%、25.00%,差异有统计学意义(P<0.05)。结论疑似肛瘘患者采用MR高分辨率T2WIFS序列联合DWI及增强扫描方法可提升诊断正确率,可为手术提供依据。

Objective To investigate the diagnostic value of high resolution magnetic resonance (MR) fat suppression T2 weighted imaging (T2WI FS) sequence combined with DWI and enhanced scanning in anal fistula. Methods A total of 40 suspected anal fistula patients underwent conventional series + high resolution T2WI FS + DWI + enhanced MR enhancement test and conventional series + high resolution T2WI FS MR conventional test.The classification of anal fistulas by two test methods were compared.Results The accuracy rates of MR enhanced examination for internal orifice,external orifice,fistula and abscess were 93.75%,95.65%,92.00% and 100.00% respectively,which were higher than those of conventional MR examination for 62.50%,65.21%, 68.00% and 70.58%.Their difference was statistically significant (P<0.05).The accuracy rate of MR enhanced examination for the inter-sphincter type,transsphincter type,supraspinal sphincter type and sphincter type was 92.86%,83.30%,90.00% and 100.00% respectively,which were higher than that of conventional MR examination for 57.14%,75.00%,40.00% and 25.00%.Their difference was statistically significant (P<0.05).Conclusion The diagnostic accuracy of suspected anal fistula patients can be improved by MR high resolution T2WI FS sequence combined with DWI and enhanced scanning,and it can provide a basis for surgery.