磁共振成像对肛门直肠周围脓肿及肛瘘的诊断效果研究

Study on the diagnostic effect of magnetic resonance imaging in perianorectal abscess and anal fistula

目的:评估磁共振成像(MRI)应用于肛门直肠周围脓肿以及肛瘘诊断中的临床价值。方法:2017年2月-2018年2月选取本院接收的肛门直肠周围脓肿/肛瘘疑似患者54例为研究对象,均给予高分辨MRI扫描,分析MRI的扫描结果,评估肛门直肠周围脓肿、肛瘘的确诊情况以及相关信号。结果:54例疑诊为肛门直肠周围脓肿/肛瘘的患者均通过手术证实,术中发现脓肿有59处,20例伴有肛瘘,有25个原发瘘管,27个内口,36个外口。与同层面肌肉相较,邻近脓肿壁T1W1,T2W1上出现52处稍低信号、5处呈等信号;中央脓腔有脓性物质出现信号不均的现象,其中脓肿T1W146处为稍低信号、T2W1为高信号,此外有10处脓肿T1W1呈现稍高信号、T2W1为高信号,脓肿壁增强扫描发现为环形强化,中央脓液未强化,其中有14例高位脓肿,40例低位脓肿。结论:高分辨MRI能够清晰呈现出肛门直肠周围脓肿、肛瘘以及肛周肌肉,有助于术者准确判断患者肛门直肠周围脓肿、肛瘘的位置、大小以及走行,观察其是否出现其他病变症状,为临床诊疗提供客观的解剖图像,具备良好的诊断优势。

Objective:To evaluate the clinical value of magnetic resonance in the diagnosis of anorectal abscess and anal fistula.Methods:The experimental samples were suspected 54 patients with anal-rectal abscess/anal fistula received by our hospital from February 2017 to February 2018,all were given high-resolution magnetic resonance imaging scans to analyze the results of magnetic resonance,Assess the diagnosis of anus and rectum abscess,anal fistula and related signals.Results:54 patients with suspected diagnosis of perianal and rectal abscess/anal fistula were confirmed by surgery.59 abscesses were found during operation,20 cases were accompanied by anal fistula,25 primary fistulas,27 internal openings,36 external openings.Compared with the muscles of the same level,there are 52 slightly lower signals and 5 equal signals on the T1W1 and T2W1 adjacent to the abscess wall;there are uneven signals in the central pus cavity with purulent substances,of which the T1W146 abscess is slightly low signal,T2W1 is hyperintensity,in addition there are 10 abscesses T1W1 presents slightly hyperintensity,T2W1 is hyperintensity,the abscess wall enhancement scan is found to be ring-shaped enhancement,the central pus is not strengthened,including 14 high abscesses and 40 low abscesses.Conclusion:High-resolution magnetic resonance imaging can clearly show the perianal and rectal abscess,anal fistula and perianal muscles,which helps the surgeon to accurately determine the location,size and travel of the patient's perianal and rectal abscess and anal fistula,and observe whether there are other pathological symptoms,Provide objective anatomical images for clinical diagnosis and treatment,with good diagnostic advantages.