高场磁共振在肛瘘诊治中的应用价值.pdfVIP

14 Journal of Xiangnan University (Medical Sciences) Dec.2014 Vol.16 No.4 高场磁共振在肛瘘诊治中的应用价值 1 1 2* 谢乐华 ,曹 波 ,肖湘生 (1南方医科大学附属深圳恒生医院影像科,广东 深圳 518102;2 上海第二军医大学长征医院,上海 200003) 摘 要:目的 探讨高场磁共振成像(MRI)在肛瘘诊断中的临床应用。 方法 35例肛瘘患者行盆腔MR平扫检 查,扫描序列包括轴位T1WI、T2WI及T2WI脂肪抑制序列,矢状面及冠状面T2WI抑脂序列。 分析肛瘘的MRI表现, 评价瘘管与内外括约肌的关系,比较内、外口的显示率,并将诊断结果与手术进行对照。 结果 33例肛瘘 MR检查结 果与手术结果一致;T2WI及T2WI脂肪抑制序列图像上,瘘管及肛周脓肿表现为高信号,于T1WI表现为条状略低信 号,以抑脂像病灶显示最佳;脓肿在DWI上呈高信号。 瘘口及瘘管MRI与手术符合率分别为94.9%及92.5%。 结论 应用高场MRI能准确定位肛瘘的内口、瘘管的走向及其与肛管直肠括约肌之间的关系,具有重要的临床实用和推广价 值。 关键词:高场磁共振;肛瘘;诊断 + 中图分类号:R657.1 6 文献标识码:A 文章编号:1673-498X(2014)04-0014-03 doi:10.3969/ j.issn.1673-498x.2014.04.005 Value of high-field MRI in diagnosis of anal fistula XIE Lehua,CAO Bo,XIAO Xiangsheng (The Radiology Department of Southern Medical University Shenzhen HengSheng Hospital, Shenzhen,Guangdong518102,China) Abstract:ObjectiveTostudytheclinicalapplicationof high-fieldof MRItothediagnosisof analfistu_ las. Methods35 caseswithanalfistulaswereacceptedMRscanningofpelvicwithoutcontrast,Scanningse_ quences includingTlWl、T2WI andT2WIfatsat inthetransverseplane,T2WIfatsat inthe sagittal plane and the coronal plane. The imaging of the anal fistulaswas analyzed. Evaluate the relationship between internal and external sphincter fistula. The types and the display of the internal and external openingswere assessed and thediagnosiswiththeoperationresultswascompared. Results33 casesof analfistulassurgery MRima_ ging results are consistent with the operation results. Fistula showed low signal in T1WI and high signal in T2WI or T2WI fatsat,Abscess showed high signal on DWI;MRIwith orificium andfis