摘要
目的探讨高分辨MR成像对肛瘘分级的价值。方法 经手术证实的肛瘘患者13例,全部接受高分辨MR检查,检查序列包括:轴位快速场回波T1WI、冠状位及轴位快速自旋回波T2WI、轴位频谱预饱和翻转恢复T2WI和增强T1高分辨力各向同性容积激励序列。评价MRI检出的瘘管、内口、外口、肛周脓肿及其数量,进行分级,并与手术所见对照。结果 13例肛瘘中,Ⅰ级1例,Ⅱ级1例,Ⅲ级1例,Ⅳ级5例,Ⅴ级5例。手术发现13例肛瘘中共有18个瘘管,11个外口,13个内口,11个肛周脓肿。MRI发现16个瘘管,11个外口,13个内口,11个肛周脓肿。MRI诊断瘘管的准确率为88.89%(16/18),检出内口的阳性率为92.86%(13/14),MRI诊断的外口位置、数目及肛周脓肿范围与手术所见一致。结论 高分辨MR成像对肛瘘可以准确分级。术前MR检查可指导外科治疗方法的选择,并能更好地预测预后。
Objective To observe the clinical value of high-resolution MRI for anal fistula classification.Methods Thirteen patients with surgically proved anal fistulas underwent preoperative high-resolution MR imaging.The imaging protocol included fast field echo（FFE） T1WI at axial planes,turbo spin echo（TSE） T2WI at axial and coronal planes,spectral presaturation inversion recover（SPIR） T2WI at axial planes and contrast-enhancement T1 high resolution isotropic volume excitation（THRIVE）.All anal fistulas were classed based-on MRI and compared with operation,including the appearances of internal fistula,extra fistula,fistula canales and perianal abscess.Results In 13 patients,1 anal fistula was grade Ⅰ,1 was grade Ⅱ,1 was grade Ⅲ,5 were grade Ⅳ and 5 were grade Ⅴ.There were 18 fistula canales,13 internal fistulas,11 extra fistulas and 11 perianal abscess in operation.MR displayed 16 fistula canales,13 internal fistulas,11 extra fistulas and 11 perianal abscess.The diagnostic accuracy of MRI for fistula was 88.89%（16/18）,the positive rate for internal fistula was 92.86%（13/14）.The site,number and perianal abscess of external fistula showed with MRI was the same with operation.Conclusion High-resolution MRI is a very accurate preoperative technique for evaluating the classification of anal fistula.Preoperative MRI can dictate the surgical procedure of choice and is an important determinant of outcome.
出处
《中国医学影像技术》
CSCD
北大核心
2011年第1期100-102,共3页
Chinese Journal of Medical Imaging Technology
关键词
磁共振成像
直肠瘘
分级
Magnetic resonance imaging
Rectal fistula
Classification
