摘要
目的 肛瘘术前MRI结合临床分型对术后复发的评估价值。方法 回顾性分析本院经手术治疗的原发性肛瘘患者53例,分为复发组(20例)和非复发组(33例),对各患者的一般临床资料、临床分型及术前MRI诊断要素进行统计学分析、单因素及多因素回归分析,并对复发患者进行生存、风险分析。结果 病史时间、SPTF分型、外口的数量、瘘道的复杂性在两组中有统计学差异(P<0.05);单因素logistic回归中,病史时间、SPTF分型、外口的数量及瘘道的复杂性分别作为独立预后因素(P<0.05),多因素logistic回归中,病史时间却成为关键因素(P=0.004),多因素logistic回归模型曲线下面积0.848,敏感性0.950,特异性0.606。复发组患者生存分析中,瘘道的复杂性这个MRI要素在复发时间上有明显相关性(P=0.022),有分支组复发时间(90天)明显小于无分支组(120天)。结论 肛瘘术前MRI结合临床分型对术后复发有一定的预测价值。
Objective The value of preoperative MRI combined with clinical typing in the evaluation of postoperative recurrence of anal fistula;Methods a retrospective analysis in our hospital after surgical treatment of primary 53 cases with anal fistula, divided into relapse group(20 cases) group(33 cases), and the recurrence in patients with the general clinical data, clinical classification and preoperative MRI in the diagnosis of factors of statistical analysis, single factor and multiple factors regression analysis, and the survival in patients with recurrent, risk analysis. Results There were statistically significant differences in onset time, SPTF type, number of orifals, and fistula complexity between the two groups(p<0.05);In univariate logistic regression, onset time, SPTF, number of orifices, and complexity of fistula were independent prognostic factors(p=0.004). The area under the curve of the multivariate logistic regression model was 0.848, the sensitivity was 0.950 and the specificity was 0.606.In the survival analysis of patients in the relapsed group, the MRI factor of fistula complexity was significantly correlated with the recurrence time(p=0.022), and the recurrence time(90 days) in the branching group was significantly less than that in the non-branching group(120 days). Conclusion PREOPERATIVE MRI combined with clinical typing has a certain predictive value for postoperative recurrence of anal fistula.
作者
游涛
谭惠斌
王叶
江远亮
黄文才
金炜东
熊飞
YOU Tao;TAN Hui-bin;WANG-Ye;JIANG Yuan-liang;HUANG Wen-cai;JIN Wei-dong;XIONG Fei(Radiology Department,General Hospital of Central Theater Command,PLA,Wuhan 430070,Hubei Province,China;Department of General Surgery,General Hospital of Central Theater Command,PLA,Wuhan 430070,Hubei Province,China)
出处
《中国CT和MRI杂志》
2023年第1期141-144,共4页
Chinese Journal of CT and MRI
基金
构建术前评估结直肠手术后吻合口漏的预测模型(WJ2018H0090)。
关键词
肛瘘
MRI
临床分型
术后复发
Anal Fistula
Magnetic Resonance Imaging
Clinical Type
Postoperative Recurrence
