【摘要】 目的探讨分析磁共振成像不同扫描序列在诊断肛瘘的价值。方法回顾性分析我院收治的术后证实为肛瘘30例患者资料,术前均行MRI检查,扫描序列:FSE T1WI平扫以及增强扫描,脂肪抑制快速恢复快速自旋回波序列(T2 fs FRFSE)以及三维容积内插快速扰相梯度回波平扫及增强扫描(3D-FSPGR),分析比较3种序列检查诊断价值。结果 30例患者共发现43个肛瘘外瘘口,T2 fs FRFSE准确显示肛瘘外瘘口18个(41.86%)、FSE T1W增强准确显示肛瘘外瘘口25个(58.14%)、3D-FSPGR准确显示肛瘘外瘘口40个(93.02%),其中3D-FSPGR对肛瘘外瘘口显示准确率显著高于T2 fs FRFSE与FSE T1WI增强(P<0.05)。T2 fs FRFSE准确显示肛瘘内瘘口10个(35.71%)、FSE T1W增强准确显示肛瘘内瘘口14个(50.00%)、3D-FSPGR准确显示肛瘘内瘘口23个(82.14%),其中3D-FSPGR对肛瘘内瘘口显示准确率显著高于T2 fs FRFSE与FSE T1WI增强(P<0.05)。T2 fs FRFSE准确显示肛瘘瘘管分支29个(56.86%)、FSE T1W增强准确显示肛瘘瘘管分支34个(66.66%)、3D-FSPGR准确显示肛瘘瘘管分支45个(88.23%),其中3D-FSPGR对肛瘘瘘管分支显示准确率显著高于T2 fs FRFSE与FSE T1WI增强(P<0.05)。结论 3DFSPGR序列是术前诊断肛瘘的敏感方法,能够提高肛瘘内、外瘘口以及肛瘘瘘管的显示率,同时联合其他扫描序列,能够获得更为明确的术前诊断结果。更多还原

【Abstract】 Objective The clinical value of different scanning sequence of magnetic resonance imaging(MRI) in the diagnosis of anal fistula was analyzed. Methods A retrospective analysis of our hospital after surgery confirmed 30 cases of anal fistula patients, the patients were examined by MRI scanning sequence: FSE T1 WI scan and enhanced scan, fast inversion recovery sequence(T2 fs FRFSE) and three-dimensional fast low angle shot imaging scan and enhanced image subtraction(3 D-FSPGR) analysis and comparison of 3 kinds of sequence, then analyzed and compared the diagnostic value of the 3 sequences. Results A total of 43 different types of anal fistula were found in 30 patients. 43 lesions were external anal fistula fistula, anal fistula and accurate display of T2 fs FRFSE 18(41.86%), FSE enhanced T1 W accurately display the external anal fistulas in 25(58.14%), 3 D-FSPGR accurately displayed outside the anal fistula fistulas in 40(93.02%), of which 3 D-FSPGR of anal fistula significant accuracy rate was significantly higher than that of T2 fs FRFSE and FSE T1 WI(P<0.05). T2 fs FRFSE accurately showed 10 lesions(35.71%) and 10 FSE(T1 W) enhancement of fistula in the anal fistula, and 14 lesions(50.00%) of the fistula in the anal fistula. The 3 D-FSPGR accurately showed 23 lesions(82.14%) of the fistula in the anal fistula, and the significant accuracy rate of 3 D-FSPGR for the anal fistula was significantly higher than that of T2 fs FRFSE and FSE T1 WI(P<0.05). T2 fs FRFSE accurately display the fistula 29 branches(56.86%), FSE enhanced T1 W accurately display the fistula 34 branches(66.66%), 3 D-FSPGR accurately display the fistula 45 branches(88.23%), of which 3 D-FSPGR of branch fistula significant accuracy was significantly higher than that of T2 fs FRFSE and FSE T1 WI(P<0.05). Conclusion 3 D-FSPGR sequence is a sensitive method for preoperative diagnosis of anal fistula. It can improve the display rate of internal fistula,external fistula and anal fistula. Combined with other scanning sequences, we can get a more clear preoperative diagnostic result.更多还原