肛瘘的磁共振诊断及应用价值

Magnetic resonance imaging diagnosis and application value of anal fistula

目的探讨肛瘘的磁共振(MR)诊断及应用价值。方法回顾性分析2016年1月至2018年12月在本院行手术治疗的76例肛瘘患者的术前MRI图像。以手术记录为标准,评价MRI诊断各种类型肛瘘的准确性。结果手术记录共有108条瘘管,内口76个,合并肛周脓肿14例(18%);单纯性肛瘘48例(63%),复杂性肛瘘28例(37%);高位肛瘘18例(24%),低位肛瘘58例(74%)。MRI诊断检出99条瘘管和67个内口,检出率分别为91.7%和88.2%。MRI对肛周脓肿,单纯性肛瘘、复杂性肛瘘,高位肛瘘、低位肛瘘的检出率与手术记录比较,差异无统计学意义(P均>0.05)。结论MRI对肛瘘诊断准确性较高,误诊风险较低,可为术前诊断提供可靠的参考资料。

Objective To evaluate the diagnostic and applicable value of magnetic resonance imaging(MRI)in anal fistula.Methods The preoperative MRI images of 76 patients with anal fistula who underwent surgical treatment in our hospital from January 2016 to December 2018 were retrospectively analyzed.The accuracy of MRI in the diagnosis of various types of anal fistula was evaluated based on the surgical records.Results A total of 108 fistulas and 76 internal openings were surgical recorded,and 14 patients(18%)had perianal abscess.There were 48 cases with simple anal fistula(63%)and 28 cases with complex anal fistula(37%),18 cases(24%)with high anal fistula and 58 cases(74%)with low anal fistula.Ninty-nine fistulas and 67 internal orifices were detected by MRI,with the detection rate of 91.7%and 88.2%,respectively.The detection rates of MRI for perianal abscess,simple anal fistula,complex anal fistula,high anal fistula and low anal fistula were not significantly different from the surgical records(all P>0.05).Conclusion MRI has high accuracy in the diagnosis of anal fistula and low risk of misdiagnosis,which can provide reliable reference data for preoperative diagnosis.