MRI检查中T_(2)WI压脂序列与DWI序列在肛瘘诊断中的应用价值比较

Comparison of application value of T_(2)WI lipid pressure sequence and DWI sequence during MRI examination in the diagnosis of anal fistula

目的比较磁共振成像(MRI)检查中T_(2)加权成像(T_(2)WI)压脂序列与弥散加权成像(DWI)序列在肛瘘临床诊断中的应用价值。方法选取2020年3月至2021年4月于本院诊治的36例肛瘘患者作为研究对象,均行MRI检查T_(2)WI压脂序列与DWI序列扫描,以手术结果及病理诊断结果作为标准,观察并记录不同检查序列对肛瘘患者肛瘘内口、瘘管的显示情况、影像学显示效果及诊断肛瘘分型的准确率。结果36例肛瘘患者共发现内口38个,瘘管46个。以手术结果为标准,T_(2)WI压脂序列对肛瘘内口、瘘管的显示率分别为94.74%(36/38)、97.83%(45/46),显著高于DWI序列的76.32%(29/38)、84.78%(39/46),差异具有统计学意义(P<0.05)。行T_(2)WI压脂序列扫描时可见明显内口影,呈高信号;行DWI序列扫描时,内口处无清晰显示。以病理诊断结果为标准,T_(2)WI压脂序列、DWI序列对肛瘘分型的诊断准确率均较高,但两种序列对括约肌间型、括约肌上型、括约肌外型、经括约肌型及皮下、黏膜下型和复杂型的诊断准确率比较,差异不具有统计学意义(P>0.05)。结论肛瘘术前诊断中,MRI检查时行T_(2)WI压脂序列、DWI序列扫描均可获得较高的肛瘘内口及瘘管显示率,与DWI序列相比,T_(2)WI压脂序列的显示效果更佳;两种不同序列对肛瘘分型的诊断准确率均较高。

Objective To compare the application value of T_(2)-weighted imaging(T_(2)WI)lipid pressure sequence and diffusion weighted imaging(DWI)sequence during MRI examination in the diagnosis of anal fistula.Methods A total of 36 patients with anal fistula diagnosed and treated in our hospital from March 2020 to April 2021 were selected as the research objects.All patients underwent MRI T_(2)WI lipid pressure sequence and DWI sequence scan.The surgical results and pathological diagnosis results were used as the criteria to observe and record the display of anal fistula internal orifice and fistula,imaging display effect and diagnostic accuracy of anal fistula classification in patients with anal fistula.Results A total of 38 internal orifice and 46 fistulas were found in 36 patients with anal fistula.Taking the results of surgical records as the standard,the display rates of internal orifice and fistula of anal fistula by T_(2)WI lipid pressure sequence were 94.74%(36/38)and 97.83%(45/46)respectively,which were significantly higher than 76.32%(29/38)and 84.78%(39/46)by DWI sequence,and the differences were statistically significant(P<0.05).T2WI lipid pressure sequence scanning showed obvious internal orifice shadow,high signal;when DWI sequence scan was performed,there was no clear display at the internal orifice.Taking the results of pathological diagnosis as the standard,the diagnostic accuracy of T_(2)WI lipid pressure sequence and DWI sequence for anal fistula classification were higher,but there were no significant differences between the two sequences in the accuracy of intersphincteric type,suprasphincteric type,external sphincter type,transsphincteric type,subcutaneous type,submucosal type and complex type(P>0.05).Conclusion In the preoperative diagnosis of anal fistula,T_(2)WI lipid pressure sequence and DWI sequence scan during MRI examination can obtain higher display rate of anal fistula internal orifice and fistula,compared with DWI sequence,T_(2)WI lipid pressure sequence has better display effect.The accuracy of two different sequences in the diagnosis of anal fistula are high.