论著-头颈部
MR平扫对肛瘘的诊 断价值及联合分型 尝试
作者:马喜娟1 师毅冰1 孙晋军1 吕璐璐1 曹 伟1 张正国2 杨 光2 郝敬明1
所属单位:1.江苏省徐州市中心医院CT/MRI室 (江苏 徐州 221009) 2.江苏省徐州市中心医院肛肠外科 (江苏 徐州 221009)
PDF摘要
目的 评价磁共振平扫对肛瘘的 诊断价值及分型价值,并尝试进行联合 分型。方法 回顾性分析25例经手术病 理证实为肛瘘患者的MR平扫资料,包括 肛瘘内口、主管、支管、伴发脓肿的数 目、位置,以及肛瘘分型,与手术结果 进行对照分析。结果 ①MR平扫对肛瘘内 口、主管、支管、脓肿诊断的灵敏度分别 为88.2%、91.2%、88.9%、100%,准确度 分别为83.3%、91.2%、92.3%、100%,阳 性预测值分别为96.8%、100%、88.9%、 100%。②对MR诊断的真阳性病例用两种 方法进行分型,并与手术分型对照, Parks分型MR符合率100%,国内分类MR符 合率87.0%,两种分型可联合应用。结论 ①1.5T MR平扫能准确诊断肛瘘内口、主 管、支管和伴发脓肿。②依据两种方法MR 平扫对肛瘘均能准确分型;两种分型联合 应用可取长补短,兼顾解剖细节与病变整 体特征,对肛瘘手术具有指导意义。
Objective To evaluate the value of magnetic resonance (MR) plain scan in the diagnosis and classification of Anal Fistulas. Then try to conduct a joint typing for all cases. Methods Retrospective analysis the MR information of 25 patients,all of which were diagnosed as anal fistulas based on surgical pathology, including the number and location of the inner mouth, the main tube, branch, associated abscess of anal fistula, and the anal fistula type, and then compared with the results of the operation. Results ① The sensitivity of MR plain scan in the diagnosis of the inner mouth, the main tube, branch, abscess was 88.2%, 91.2%, 88.9% and 100% respectively, the accuracy was 83.3%, 91.2%, 92.3% and 100% respectively, the positive predictive values was 96.8% and 100%, 88.9%, 100% respectively. ② The true positive cases of MR diagnosis were classified by two methods and compared with the surgical typing. The compliance rate of Parks was 100%, and the coincidence rate of MR was 87.0%. The two types can be combined. Conclusion ① 1.5T MR plain scan can accurately diagnose the inner mouth, the main tube, branch and associated abscess of anal fistula. ② MR plain scan can be used for accurate classification of anal fistula in two ways. The combination of the two types is complementary to each other, taking into account the anatomical details and the overall characteristics of the lesion, so joint typing has a guiding significance to the anal fistula surgery.
【关键词】肛瘘;磁共振成像;诊断;联 合分型
【中图分类号】R657.1+6
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2017.12.036
前言
肛瘘指肛管或直肠与肛门或肛周皮肤相通的异常通道,一般由内 口、瘘管、外口组成,三者均有的有内外瘘、全内瘘、全外瘘,单个 开口的有内盲、外盲瘘。肛瘘一般需手术治疗,瘘管的位置、数目、 走行、分支、内口位置和病变周围结构的准确评估,对选择手术方式 和降低复发率具有重要意义[1]。MR软组织分辨率高,可清晰显示盆底 解剖结构。本文回顾性分析25例肛瘘患者的术前MR资料,以手术结果 为金标准,评价MR平扫对肛瘘内口、瘘管主管、支管、脓肿的诊断价 值及肛瘘分型价值,并尝试两种分型联合应用。
中国CT和MRI杂志
第15卷, 第 12 期
2017年12月
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