术前MRI多平面成像对肛瘘及其分型的诊断价值

Diagnostic Value of Preoperative MRI Multiplanar Imaging for Anal Fistula and Classification

目的分析术前MRI多平面成像对肛瘘及其分型的诊断价值。方法方便选择该院2014年10月—2019年3月所收治50例经手术病理检查结果确诊的肛瘘患者,术前均接受MRI检查,比较分析MRI检查结果与手术病理检查结果。结果术前MRI检查结果显示,全部50例肛瘘患者中,括约肌间型27例,经括约肌型13例,括约肌上型3例,括约肌外型2例;和术后手术结果相比较,MRI检查括约肌间型的诊断准确率为96.4%,经括约肌型的诊断准确率为86.7%,括约肌上型的诊断准确率为75.0%,括约肌外型的诊断准确率为66.7%。在外口数目及肛周脓肿范围方面术前MRI与术后手术结果相同;MRI在瘘管、支管、内口的诊断准确率分别为95.3%、83.3%、87.3%。结论术前MRI多平面成像不但能对肛瘘进行准确分型,而且还能对肛瘘的分支瘘管、外口以及内口进行准确显示,能为术前诊断提供详细和准确的影像解剖信息,值得临床推广和应用。

Objective To analyze the diagnostic value of preoperative MRI multiplanar imaging for anal fistula and classification.Methods 50 patients with anal fistula diagnosed by operation and pathology in our hospital from October 2014 to March 2019 were convenient selected.all patients underwent MRI before operation.The results of MRI and surgical pathology were compared.Results Preoperative MRI showed that in all 50 patients with anal fistula,there were 27 cases of sphincter type,13 cases of sphincter type,3 cases of sphincter type,and 2 cases of sphincter type;compared with postoperative results,the diagnostic accuracy of MRI examination of sphincter type was 96.4%,the diagnostic accuracy of sphincter type was 86.7%,the diagnostic accuracy of sphincter type was 75.0%,and the diagnostic accuracy of sphincter type was 66.7%.The number of external orifices and the range of perianal abscess diagnosed by preoperative MRI were completely consistent with the postoperative surgical results,and the diagnostic accuracy of MRI in the fistula,branch and internal orifice were 95.3%,83.3%,and 87.3%,respectively.Conclusion Preoperative MRI multiplanar imaging can not only accurately classify anal fistula,but also accurately display the branch fistula,external orifice and internal orifice of anal fistula,and provide detailed and accurate image anatomy information for preoperative diagnosis,it is worthy of clinical promotion and application.