【摘要】 目的探讨MRI中使用直肠球囊双腔导管(BRDCC)在肛瘘患者诊断中的应用价值。方法 36例经手术证实的肛瘘患者于术前行MRI,其中18例使用BRDCC,另18例未使用。对36例患者瘘管、内口、分支及脓腔进行计数。所获结果被用于评估肛瘘MR诊断分型,并同时与手术结果相对照。采用Microsoft Office Excel处理软件分析数据,根据MRI图像对36例瘘管末端位置、内口、分支及脓腔分别进行计数和分型,与手术结果对照计算准确率及运用Chi-square检验观察有无统计学意义。结果 18例使用BRDCC的肛瘘患者MRI上共发现瘘管20支、内口21个、分支10支以及脓腔9个。Park’s分型中8例为括约肌间型,9例为经括约肌型,1例为括约肌外型。与手术结果比较,分型与手术结果一致,瘘管(20/21)、内口(21/22)、分支(10/10)和脓腔(9/9)的准确性分别为95.24%、95.45%、100%和100%;没有1例高低位误诊。18例未使用球囊导管的患者,MRI共发现瘘管26支、内口21个、分支15支以及脓腔6个,Park’s分型中6例为括约肌间型,10例为经括约肌型,1例为括约肌外型,1例为括约肌上型。与手术结果比较,瘘管(26/28)、内口(21/27)、分支(15/16)和脓腔(6/6)的准确性分别为92.86%、77.78%、93.75%和100%,有4例高低位误诊。使用BRDCC对肛瘘患者高低位的显示要显著优于未使用BRDCC者(χ2=15.9,P=0.033)。结论通过使用BRDCC,MRI能够获得更多有关瘘管及其走行的信息。更多还原

【Abstract】 Objective To investigate the value of conventional MR combined with balloon rectal double channel catheter(BRDCC) in the diagnosis of perianal fistula.Methods Thirty six patients with perianal fistula confirmed by operation were divided into 2 groups equally.The patients of group 1(n=18) underwent MR scan with BRDCC and group 2(n=18)patients without BRDCC.The number of fistulas,the internal openings,branches and abscesses were counted.All MR findings were utilized for classification of the fistulas and compared with the surgery results.Results On MR imagings,20 fistulas,21 internal openings,10 branches and 9 abscesses were observed of 18 patients with BRDCC.There were 8 intersphincteric,9 transsphincteric and 1 suprasphincteric fistulas according to Park’s Classification.Compared with operation results,the MR findings with BRDBCC had high accuracy and consistency in displaying preianal fistulas(20/21,95.24%),interning openings(21/22,95.45%),branches(10/10,100%),abscesses(9/9,100%)and classification.For another 18 patients without BRDCC,there were 26 fistulas,21 internal openings,15 extensions and 6 abscesses were detected.Compared with operation findings,the accuracy of MR without BRDBCC in displaying fistula,interning openings,branches and abscesses were 92.86%,77.78%,93.75% and 100%.It revealed significant differences of the location of fistulas between two groups(χ2=15.9,P= 0.033).Conclusion Using BRDCC,conventional MRI can provide more information of periananlfistulas.更多还原