【摘要】 目的评价磁共振扩散加权成像序列(DWI)结合常规序列对复杂性肛瘘显示的准确性,探讨DWI在复杂性肛瘘中的应用价值。方法 30例经手术证实的复杂性肛瘘患者术前均行MRI检查,扫描序列包括常规序列横轴位T1WI、T2WI、T2WI脂肪抑制,冠状位、矢状位T2WI脂肪抑制及DWI,以手术结果为标准,分别观察并比较评估常规扫描序列和常规扫描序列+DWI对肛瘘瘘管、内口及脓肿的显示情况。结果 30例肛瘘患者,MR常规扫描序列诊断内口灵敏度为81.4%(38/43),阳性预测值为8 9.7%(3 5/3 9);瘘管灵敏度为9 0.2%(3 7/4 1),阳性预测值8 6.0%(3 7/4 3);脓肿灵敏度9 1.6%(1 1/1 2),阳性预测值1 0 0%(1 1/1 1);常规序列+D W I诊断内口灵敏度9 5.3%(4 1/4 3),阳性预测值9 5.3%(4 1/4 3),瘘管灵敏度9 2.7%(3 8/4 1),阳性预测值9 7.4%(3 8/3 9),脓肿灵敏度100%(12/12),阳性预测值100%(12/12),两种诊断方法比较,常规序列+DWI对肛瘘的诊断效果要优于常规序列,其中对内口的显示灵敏度有统计学差异(P<0.05)。结论磁共振常规序列+DWI显示肛瘘内口、瘘管及脓肿具有较高的临床应用价值,可以作为外科手术前的常规检查。更多还原

【Abstract】 Objective To evaluate the accuracy of diffusion weighted imaging(DWI) combined with generic sequence in complex anal fistula and to discuss the application value of DWI in complex anal fistula. Methods 30 cases of patients who were confirmed with complex anal fistula were given MRI before operation. Scan sequences included axial T1 WI, T2 WI and fat sequence T2 WI, and coronal and sagittal fat sequence T2 WI and DWI. With surgical results as the standard, conventional sequences and conventional sequences + DWI were compared for anal fistula, internal opening and abscess. Results For 30 cases of patients with anal fistula, sensitivity and positive predict value of MR conventional sequences were 81.4%(38/43) and 89.7%(35/39) respectively for internal opening; 90.2%(37/41) and 86.0%(37/43) for anal fistula; 91.6%(11/12) and 100%(11/11) for abscess. Sensitivity and positive predict value of MR conventional sequences + DWI were 95.3%(41/43) and 95.3%(41/43) for internal opening; 92.7%(38/41) and 97.4%(38/39) for anal fistula; 100%(12/12) and 100%(12/12) for abscess. In comparison of two kinds of diagnostic methods, conventional sequences + DWI had better diagnostic results on anal fistula than conventional sequences, and the sensitivity for internal opening was of statistical difference(P<0.05). Conclusions MRI + DWI shows higher clinical application value for internal opening and canal of anal fistula and abscess, which can be used as a conventional preoperative examination.更多还原