MR不同序列成像诊断肛瘘的研究

The research on comparing the result of anal fistula diagnose with different MR pulse sequences

目的 采用不同的序列诊断肛瘘 ,比较评价不同序列的临床应用价值。方法 15例临床怀疑肛瘘的患者 ,磁共振扫描序列 :SET1WI平扫及增强扫描 ,快速反转恢复序列 (turboinversionrecoverymagnitude ,TIRM ) ;三维快速小角度激发成像平扫和增强图像减影 (3D fastlow angleshotimage ,3D FLASH )及冠状面重建 ,比较 3种序列肛瘘内、外瘘口及瘘管分支显示率。结果 1例为肛周脓肿 ,余 14例患者发现 2 4个不同类型的肛瘘 ,10例伴肛周脓肿 ,其中 8例存在复杂性多分支瘘 ,3D FLASH对肛瘘内、外口及瘘管系统显示率均高于SET1WI增强及TIRM序列。结论 3D FLASH序列是诊断肛瘘的敏感检查方法 。

Objective To elevate the clini cal value of different MR pulse sequences in the diagnose of anal fistula. Methods Fifteen cases with clinically suspected anal fistula were included in this study. MR pulse sequences included spin echo T 1WI, turbo inversion recovery magnitude (TIRM), fast low-angle shot image (FLASH), non-enhancement and enhancement subtraction and coronary reconstructing. The display rate of internal fistula, extra fistula, and the branch of fistula canales was compared in three kinds of sequences. Results Perianal abscess was found in 1 case. 24 different kinds of anal fistula were revealed in the other 14 patients. Ten of them were complicated with perianal abscess, and 8 of them complicated with complex multi-branch fistula. The display rate of 3D-FLASH sequence was much higher than those of T 1WI and TIRM in all cases. Conclusion 3D-FLASH sequence is a sensitive method to diagnose the anal fistula and it can reduce the examination time.