常规MRI序列联合DWI在肛瘘诊断中的价值

The value of conventional MRI sequence combined with DWI in the diagnosis of anal fistula

目的:探讨常规MRI序列联合弥散加权成像(diffusion weighted imaging,DWI)在肛瘘诊断中的价值。方法:选取广州市中西医结合医院2019年1月—2020年12月共经手术证实的42例肛瘘患者,术前均行常规MRI序列(包括TWI、T抑脂序列及TWI增强)和DWI检查,比较常规MRI序列、DWI及两者对肛瘘诊断的敏感度。结果:术中共发现内口56个,瘘管64条。TWI/T抑脂显示40个内口,敏感度为71.4%,53条瘘管,敏感度为82.8%;TWI增强显示45个内口,敏感度为80.4%,58条瘘管,敏感度为90.6%;DWI显示内口35个,敏感度为62.5%,瘘管49条,敏感度为76.6%;常规MRI(包括TWI/T抑脂及TWI增强)及联合DWI共显示51个内口,敏感度为91.1%,61条瘘管,敏感度为95.3%。结论:常规MRI序列是诊断肛瘘的主要方法,DWI对肛瘘诊断具有一定的价值,常规MRI序列联合DWI可提高肛瘘的检出率。

Objective To explore the value of conventional MRI sequence combined with DWI in the diagnosis of anal fistula.Methods A total of 42 patients with anal fistula confirmed by surgery in Guangzhou integrated traditional Chinese and Western medicine hospital from January 2019 to December 2020 were selected.Before operation,conventional MRI sequence(including T_(2)WI,T_(2) lipid suppression sequence and T_(1)WI enhancement)and DWI were performed.The sensitivity of conventional MRI sequence,DWI and both to the diagnosis of Anal Fistula was compared.Results A total of 56 internal openings and 64 fistulas were found.T_(2)WI/T_(2) lipid suppression showed 40 internal openings,the sensitivity was 71.4%,and 53 fistulas,the sensitivity was 82.8%;Enhanced T_(1)WI showed 45 internal openings with a sensitivity of 80.4%and 58 fistulas with a sensitivity of 90.6%;DWI showed 35 internal openings,with a sensitivity of 62.5%,and 49 fistulas,with a sensitivity of 76.6%;Conventional MRI(including T_(2)WI/T_(2) lipid suppression and T_(1)WI enhancement)and combined DWI showed 51 internal openings,with a sensitivity of 91.1%and 61 fistulas,with a sensitivity of 95.3%.Conclusion Conventional MRI sequence is the main method in the diagnosis of Anal Fistula.DWI is of certain value in the diagnosis of Anal Fistula.Conventional MRI sequence combined with DWI can improve the detection rate of Anal Fistula.