术前MRI多参数成像诊断肛提肌上脓肿的临床价值

Clinical value of preoperative multiparametric MRI in the diagnosis of supralevator abscess

目的探讨术前磁共振成像(MRI)多参数成像对肛提肌上脓肿的诊断及内口显示的临床价值。方法回顾性分析我院203例经MRI多参数成像诊断为肛周脓肿患者的临床资料,以手术结果为诊断金标准,分析单独T_(2)WI、单独DWI和T_(2)WI联合DWI序列对肛提肌上脓肿内口显示的诊断准确度。结果203例患者中,有40例术中诊断为肛提肌上脓肿,而术前MRI诊断肛提肌上脓肿有39例,诊断准确度为97.5%。术前MRI共发现肛提肌上脓肿合并内口29例,术后证实合并内口32例,T_(2)WI联合DWI序列对内口的显示准确度为94.5%(52/55)。T_(2)WI联合DWI序列对内口的显示准确度高于单独T_(2)WI序列(P<0.05)。结论MRI多参数成像在术前诊断肛提肌上脓肿有较高的准确性,T_(2)WI联合DWI序列诊断内口的准确度高于单独T_(2)WI序列,其能够明确病变涉及范围、与肛提肌关系及内口数目,为临床术前方案的制定提供准确的解剖学信息,具有很高的临床应用价值。

Objective To explore the clinical value of preoperative multiparametric magnetic resonance imaging(MRI)in the diagnosis of supralevator abscess and display of internal orifice.Methods The clinical data of 203 patients with perianal abscess diagnosed by multiparametric MRI in our hospital were analyzed retrospectively.Taking the surgical results as the diagnostic gold standard,the diagnostic accuracy of T_(2)WI alone,DWI alone and T_(2)WI combined with DWI sequence in the display of the internal orifice of supralevator abscess were analyzed.Results Among 203 patients,40 cases were diagnosed as supralevator abscess during operation,while 39 cases were diagnosed as supralevator abscess by preoperative MRI,the diagnostic accuracy was 97.5%.A total of 29 cases of supralevator abscess with internal orifice were found by MRI before operation,and 32 cases were confirmed after operation.The accuracy of T_(2)WI combined with DWI sequence was 94.5%(52/55).The display accuracy of internal orifice of T_(2)WI combined with DWI sequence was higher than that of T_(2)WI sequence alone(P<0.05).Conclusion Multiparametric MRI has high accuracy in the preoperative diagnosis of supralevator abscess.The accuracy of T_(2)WI combined with DWI sequence in the diagnosis of internal orifice is higher than that of T_(2)WI sequence alone.It can clarify the scope of lesions,the relationship with levator ani muscle and the number of internal orifice,provide accurate anatomical information for the formulation of clinical preoperative plan,and has high clinical application value.