摘要
目的探讨倒立位X线片与MRI检查在先天性肛门直肠畸形(CARM)诊断中的临床应用价值。资料与方法收集经手术治疗并确诊的38例CARM患儿,术前均行倒立位X线片与MRI检查。判断直肠盲端与耻尾线的关系及肛门闭锁的类型,比较倒立位X线片与MRI检查诊断CARM类型的准确率。结果 38例患儿中,低位肛门闭锁型CARM 19例,中位肛门闭锁型CARM 8例,高位肛门闭锁型CARM 11例。倒立位X线片诊断CARM类型的准确率为92.1%(35/38),MRI诊断CARM类型的准确率为97.4%(37/38),差异无统计学意义(χ2=1.37,P>0.05)。MRI可以发现瘘管7例,脊髓病变5例,右肾缺如1例。结论倒立位X线片与MRI检查均能较准确地诊断CARM类型,MRI还可以诊断CARM伴发的瘘管、内脏、脊髓病变等其他畸形,较倒立位X线片检查具有更高的临床应用价值。
PurposeTo investigate the clinical value of inverted X-ray plain film and MRI examination in the diagnosis of congenital anorectal malformation （CARM）. Materials and Methods Thirty-eight cases with operatively proved anorectal malformation were reviewed; inverted X-ray plain film and MRI examination were performed in all patients before surgery. The relationship between the rectum blind side and pubococcygeal line （PC line）, and the type of anal atresia was determined, to compare the diagnostic accuracy of inverted plain film with MRI for CARM typing. Results Of all the 38 cases, 19 cases were with low imperforate anus, 8 cases with median imperforate anus, and 11 cases with high imperforate anus. The accuracy rate of inverted X-ray plain film and MRI examination for the diagnosis of CARM typing was 92.1% （35/38） and 97.4% （37/38） respectively, and the difference between them was not statistically significant （χ^2=1.37, P〉0.05）. 7 cases of fistula, 5 cases of spinal cord malformations and 1 case of right kidney agenesis can be clearly demonstrated on MRI. Conclusion Both inverted X-ray plain film and MRI can diagnose the typing of CARM accurately, but MRI is also able to diagnose the fistula, visceral, spinal cord lesion and other abnormalities accompanied with CARM, while reducing the dose of X-ray radiation and damage in children, thus has higher clinical application value compared with inverted X-ray plain film.
出处
《中国医学影像学杂志》
CSCD
北大核心
2015年第4期306-308,310,共4页
Chinese Journal of Medical Imaging
关键词
肛管畸形
直肠畸形
先天畸形
放射摄影术
磁共振成像
婴儿
新生
Anal canal abnormalities
Rectum abnormalities
Congenital abnormalities
Radiography
Magnetic resonance imaging
Infant,newborn
