MRI对耻骨直肠肌变化与后位肛周脓肿关系的研究

Magnetic resonance imaging study on the correlation between changes in the puborectalis muscle and posterior perianal abscess

目的探讨MRI检测肛周脓肿与耻骨直肠肌厚度之间的关系。方法选取2015-2018年山东大学附属千佛山医院肛肠外科收治的107例肛周脓肿患者,包括63例低位后位肛周脓肿患者(低位组),44例高位后位肛周脓肿患者(高位组)和46例健康志愿者(对照组),均采用仰卧位分别行MRI检查,测量肛门截石位5、6、7点耻骨直肠肌的厚度。结果对照组在截石位5、6、7点耻骨直肠肌厚度分别为(5. 5 ±0.8)、(9.0 ±0.7)、(5.4 ±0.6)mm,低位组分别为(5.4 ±0.7)、(10.0±0.9)、(5.5±0.7)mm,高位组分别为(7. 3 ± 1. 0)、( 11. 7 ± 1. 2)、(7. 5 ±0. 9) mm。对照组与低位组的耻骨直肠肌厚度在截石位6点比较差异有统计学意义(I = 6. 492,P <0. 05),5、7点比较差异均无统计学意义0=-0.719,0. 633,均P>0.05)。对照组与高位组分别在截石位5、6、7点比较差异均有统计学意义(f = 9. 476,12. 875、13. 649,均P<0. 05)。低位组与高位组耻骨直肠肌厚度在截石位5、6、7点比较差异均有统计学意义0 =-11. 206、-7. 835、-13.361,均P<0.05)。结论 MRI通过测量耻骨直肠肌厚度可诊断不同部位的肛周脓肿,为早期施行干预治疗提供有力的证据。

Objective To investigate the correlation between posterior perianal abscess and thickness of the puborectalis muscle by magnetic resonance imaging. Methods Sixty-three patients with a low-position posterior perianal abscess ( the low-position group), 44 patients with a high-position posterior perianal abscess (the high-position group) and 46 healthy volunteers ( the control group) were enrolled in this study. In the lithotomy position, MRI was performed to measure the thicknesses of the puborectalis muscle at the 5 , 6 and 7 ozclock positions of the rectum. Results The thickness of puborectalis muscle at 5 , 6 and 7 o'clock points in the control group was (5. 5 ±0. 8),(9. 0 ±0. 7),(5. 4 ±0. 6) mm, while that in the low-position group was (5. 4 ±0. 7),(10. 0 ±0. 9),(5.5 ±0. 7) mm, and that in the high-position group was (7. 3 ± 1. 0),(11.7 ±1.2),(7.5 ±0. 9) mm, respectively. The thicknesses of the puborectalis muscle at the 5, 6, and 7 ozclock positions of the rectum in the lithotomy position were compared between the control group and the low-position group . The difference in the thickness at the 6 clock position was statistically significant (￡= 6. 492, P < 0. 05 ), but there were no significant differences at 5 and 7 points (i =-0. 719,0. 633 , P > 0. 05 ). The thicknesses of the puborectalis muscle at the 5 , 6 and 7 ozclock positions of the rectum in the lithotomy position were compared between the control group and the highposition group, and the differences were statistically significant at each position (/=9. 476,12. 875,13. 649, P V 0. 05). Simultaneously, the differences between the low-position group and the high-position group were statistically significant (t --11. 206,- 7. 835,- 13. 361, P < 0. 05). Conclusions Magnetic resonance imaging can diagnose perianal abscess in different parts by measuring the thickness of puborectal muscle,which provides strong evidence for early intervention treatment, so as to improve the therapeutic effect and reduce post-operative anal fistula.