3.0T高分辨率磁共振成像在肛瘘诊断及分型中的应用

目的探讨3.0T高分辨MRI在肛瘘术前诊断及分型的应用价值。方法选取经手术证实的51例肛瘘患者的临床资料及MRI表现,并与手术结果对照分析,总结肛瘘的MRI表现特点及应用价值。结果51例肛瘘手术显示内口56个,外口43个,主瘘管51条、瘘管分支14条,脓肿16个。与手术结果对照,术前MRI显示肛瘘内、外口、主瘘管及支管的准确率分别为94.64%(53/56个)、100%(43/43个)、94.12%(48/51条)及85.71%(12/14条),对脓肿显示的准确率为100%(16/16个)。按照Parks分型,51例患者MRI共检出括约肌间型肛瘘23例(45.10%),经括约肌型肛瘘17例(33.33%),括约肌上型肛瘘7例(13.73%),括约肌外型肛瘘4例(7.84%),MRI分型准确率为96.08%(49/51例)。MRI在肛瘘Parks分型上与手术结果一致性高,差异无统计学意义(P>0.05)。结论MRI能准确显示肛瘘内、外口的位置,瘘管的数量及走行,能够对肛瘘进行准确分型。

The application of 3.0T high resolution MRI in diagnosing and typing anal fistula

Objective To study the value of preoperative 3.0T high resolution MRI in diagnosing and typing anal fistula.Methods The clinical data and MRI findings of 51 operated patients with anal fistula were analyzed retrospectively,and compared with pathological results of the operations,the manifestation and application value of MRI in anal fistula were summarized.Results 51 cases of anal fistula showed 56 internal openings,43 external openings,51 primary tracts,14 small tracts,and 16 abscesses.Compared with surgical results,the accuracy of MRI was 94.64%(53/56)for internal openings,94.12%(48/51)for primary tracts,85.71%(12/14)for small tracts,100%(43/43)for external openings and 100%(16/16)for abscesses respectively.According to the Parks type,the 51 anal fistulas included 23 intersphincteric fistulas(45.10%),17 transphincteric fistulas(33.33%),7 suprasphincteric fistulas(13.73%),7 extrasphincteric fistulas(7.84%).The coincidence of MRI classification was 96.08%(49/51).There was no statistical difference between the accuracy of MRI showing the Parks type with surgical results(P>0.05).Conclusion MRI can accurately display the position of the internal and external openings,the number and form of the tracts,and type about anal fistula.