肛瘘的MRI表现与手术病理结果对照分析

Comparative Analysis of MRI Features and Pathological Results of Anal Fistula

目的探讨MRI对肛瘘及肛周脓肿的诊断价值。方法对87例经手术证实的肛瘘患者的临床资料进行回顾性分析,将MRI表现与手术结果进行对比,总结MRI在肛瘘及肛周脓肿中的诊断价值。结果87例肛瘘病例手术病理结果:内口101个,主瘘管106条,分支43条,脓肿52个。与手术结果相比较,MRI显示肛瘘内口的准确率为86.1%(87/101),显示主瘘管的准确率为90.6%(96/106),显示瘘管分支的准确率为76.7%(33/43),显示脓肿(52/52)的准确率为100%。根据Parks分型,MRI分型与手术结果比较符合率为90.8%(79/87),MRI分型与手术结果一致性检验的Kappa值为0.817,MRI分型与手术结果一致性很好。结论MRI对于显示肛瘘内口的位置、瘘管的走行、脓肿的位置及大小准确率高,能够提示肛瘘的活动性,并能准确对肛瘘进行分型。

Objective To investigate the value of MRI in the diagnosis of anal fistula and perianal abscess.Methods The clinic data of 87 patients with anal fistula diagnosed by operation were retrospectively analyzed.The MRI findings were compared with the surgical results.The MRI diagnostic value of anal fistula and perianal abscess were summarized.Results The pathological results of 87 cases of anal fistula included 101 internal orifices,106 main fistulas,43 branches and 52 abscesses.Compared with the surgical results,the accuracy of MRI in displaying the internal opening of anal fistula was 86.1%(87/101),the accuracy in displaying the main fistula was 90.6%(96/106),and the accuracy in displaying the branches of the fistula was 76.7%(33/43),showing abscesses(52/52)with 100%accuracy.According to Parks classification,the coincidence rate between MRI classification and surgical results was 90.8%(79/87),and the Kappa value of consistency test was 0.817.MRI classification is in good agreement with surgical results.Conclusion MRI can accurately display the position of the internal opening of anal fistula,the course of fistula,the position and size of abscess,indicate the activity of anal fistula,and accurately classify anal fistula.