[1]江慎林,余辉兴,彭 宏,等.磁共振成像在肛瘘脓肿疾病中的影像学表现及诊断价值分析[J].医学信息,2021,34(24):169-171.[doi:10.3969/j.issn.1006-1959.2021.24.045]
　JIANG Shen-lin,YU Hui-xing,PENG Hong,et al.The Imaging Manifestations and Diagnostic Value of Magnetic Resonance Imaging in Anal Fistula and Abscess Diseases[J].Medical Information,2021,34(24):169-171.[doi:10.3969/j.issn.1006-1959.2021.24.045]
点击复制

磁共振成像在肛瘘脓肿疾病中的影像学表现及诊断价值分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年24期
页码:
169-171
栏目:
诊疗技术
出版日期:
2021-12-15

文章信息/Info

Title:
The Imaging Manifestations and Diagnostic Value of Magnetic Resonance Imaging in Anal Fistula and Abscess Diseases
文章编号:
1006-1959（2021）24-0169-03
作者:
江慎林; 余辉兴; 彭 宏; 等
（景德镇市中医医院CT/MR室，江西 景德镇 333000）
Author(s):
JIANG Shen-lin; YU Hui-xing; PENG Hong; et al.
(CT/MR Room,Jingdezhen Hospital of Traditional Chinese Medicine,Jingdezhen 333000,Jiangxi,China)
关键词:
磁共振成像; 肛瘘脓肿; 影像学表现
Keywords:
Magnetic resonance imaging; Anal fistula abscess; Imaging manifestations
分类号:
R445.2；R657.1
DOI:
10.3969/j.issn.1006-1959.2021.24.045
文献标志码:
A
摘要:
目的 研究磁共振成像在肛瘘脓肿疾病中的影像学表现及诊断价值。方法 选取2019年5月-2021年5月在我院诊治的68例肛瘘脓肿疾病患者为研究对象，均进行磁共振检查，以手术病理结果为金标准，比较磁共振成像诊断结果、磁共振诊断效能（准确率、敏感度、特异性）、不同肛瘘分型诊断符合率和磁共振对肛瘘内口、主管、支管以及脓肿表现，不同肛瘘分型磁共振成像影像学特点。结果 磁共振术前检查显示68例患者中，单纯性肛瘘52例，复杂性肛瘘16例，与经手术探查结果比较，差异无统计学意义（P＞0.05）；磁共振诊断准确率为97.06%，敏感度为90.91%，特异度为75.00%。磁共振成像术前诊断括约肌间型、经括约肌型、括约肌上型、括约肌外型诊断结果与手术探查结果比较，差异无统计学意义（P＞0.05）；磁共振成像术前诊断肛瘘内口、主管、支管以及脓肿的数目与手术诊断结果比较，差异无统计学意义（P＞0.05）；影像学表现：肛周脓肿呈脓腔样改变，壁较厚，形态呈类圆形、不规则或马蹄形，与周围组织分解不欠清楚，T1WI呈稍低信号、T2WI呈高信号；中央脓腔为信号不均的脓性物质，T1WI呈稍低信号、T2WI呈高信号；增强扫描脓肿壁呈环形强化，中央脓液不强化；瘘管在T1WI上表现为管状低信号，T2WI级脂肪抑制像上呈高信号，增强扫描明显强化。结论 磁共振成像对肛瘘脓肿疾病诊断快速、无创，诊断准确率高，且可准确分型，定位瘘管、内口数目、部位以及累及范围，为临床治疗提供可靠的参考依据。
Abstract:
Objective To study the imaging manifestations and diagnostic value of magnetic resonance imaging in anal fistula abscess.Methods A total of 68 patients with anal fistula abscess disease diagnosed and treated in our hospital from May 2019 to May 2021 were selected as the research objects. All patients underwent magnetic resonance examination. The surgical pathological results were used as the gold standard to compare the diagnostic results of magnetic resonance imaging, the diagnostic efficacy of magnetic resonance imaging (accuracy, sensitivity, specificity), the diagnostic coincidence rate of different anal fistula types, the performance of magnetic resonance imaging on the internal orifice, main canal, branch canal and abscess of anal fistula, and the imaging characteristics of magnetic resonance imaging of different anal fistula types.Results Magnetic resonance preoperative examination showed that there were 52 cases of simple anal fistula and 16 cases of complex anal fistula in 68 patients, and the difference was not statistically significant compared with the results of surgical exploration (P>0.05). The diagnostic accuracy of MRI was 97.06%, the sensitivity was 90.91%, and the specificity was 75.00%. There was no significant difference between the results of magnetic resonance imaging preoperative diagnosis of intersphincteric type, transsphincteric type, suprasphincteric type and extrasphincteric type and results of surgical exploration (P>0.05). There was no statistically significant difference in the number of anal fistula orifices, supervisors, branches and abscesses diagnosed by magnetic resonance imaging before operation compared with the surgical diagnosis results (P>0.05). Imaging findings: perianal abscess showed abscess-like changes, thick wall, round-like, irregular or horseshoe shape, unclear decomposition with surrounding tissues, slightly low signal on T1WI, and high signal on T2WI; the central abscess cavity was a purulent substance with uneven signal, with slightly low signal on T1WI and high signal on T2WI; enhanced scan abscess wall showed ring enhancement, central abscess did not strengthen; the fistula showed tubular low signal on T1WI, and high signal on T2WI fat suppression image, which was significantly enhanced by enhanced scanning.Conclusion Magnetic resonance imaging is fast, non-invasive, and has high diagnostic accuracy in the diagnosis of anal fistula and abscess diseases. It can accurately classify, locate the number, location and range of fistula and internal orifice, and provide reliable reference for clinical treatment.

参考文献/References:

[1]王军大,崔渺,李艳艳,等.MRI钆剂瘘管造影与DCE-MRI联合使用对高位复杂型肛瘘细小分支瘘管及瘘口的诊断价值[J].重庆医科大学学报,2018,43(1):60-65.[2]陈伟,覃麟.挂实线术联合瘘管部分切开术治疗肛周脓肿并肛瘘患者的临床观察[J].结直肠肛门外科,2017,23(1):63-67.[3]张芳,陈军,刘四斌,等.3.0T磁共振3D CUBE T2WI抑脂序列对肛瘘的诊断价值[J].临床放射学杂志,2016,35(9):1390-1393.[4]Bukavina L,Tilburt JC,Konety B,et al.Perceptions of Prostate MRI and Fusion Biopsy of Radiation Oncologists and Urologists for Patients Diagnosed with Prostate Cancer:Results from a National Survey[J].Eur Urol Focus,2020,6(2):273-279.[5]严吉夫,李根海,马利安,等.切开引流加挂线术治疗坐骨直肠窝脓肿或肛管后深间隙脓肿效果分析[J].中国乡村医药,2019,26(6):17-18.[6]曾庆千,黄奕妆,雷苑麟,等.高场磁共振在肛门直肠周围 脓肿及复杂肛瘘诊断中的临床应用价值[J].深圳中西医结合杂志,2017,27(5):86-87,199.[7]夏天,徐安辉,李守卫,等.腔内超声和磁共振成像复杂性肛瘘术前诊断中的应用价值对比[J].腹部外科,2018,31(3):186-188,198.[8]王亚静.核磁共振成像对直肠肛管周围脓肿及肛瘘的临床诊断价值探讨[J].影像研究与医学应用,2018,2(10):159-160.[9]程静,赵云超,刘兴旺.肛门直肠周围脓肿及肛瘘MRI诊断(附45例报告)[J].医学影像学杂志,2017,27(2):302-305.[10]王伟,王姗姗,栾丽,等.肛门直肠周围脓肿及肛瘘的高分辨MRI诊断[J].新疆医学,2016,45(11):1619-1621.[11]赵静毅,陈成诗,吴桐,等.磁共振诊断肛门直肠周围脓肿、肛瘘的临床研究[J].黑龙江医药科学,2019,42(3):217-218.[12]Garrido-Abad P,Rodríguez-Cabello M,Platas-Sancho A.Analysis of success predictive factors in the treatment of urinary lithiasis byextracorporeal shock wave lithotripsy.patient optimization:ESWL score[J].Arch Esp Urol,2017,70(8):715-724.[13]吕茜婷,高知玲,李珊玫,等.3.0T磁共振多序列成像在复杂肛瘘诊断中的临床应用[J].中国医学计算机成像杂志,2016,22(4):331-335.[14]张莲,蔡卫东,孙希文,等.MRI肛瘘内口诊断在治疗中的价值:磁共振PDWI抑脂与增强T1WI抑脂序列的对照研究[J].中国医学计算机成像杂志,2016,22(5):435-439.[15]周晶晶,朱斌,牛磊,等.肛瘘磁共振检查的临床价值研究[J].中国CT和MRI杂志,2016,14(3):99-101.[16]尤亮.3.0T磁共振成像在肛管直肠周围脓肿及肛瘘术前诊断中的价值分析[J].影像研究与医学应用,2020,10(4):43-45.[17]范伟雄,于昭,程凤燕,等.肛门直肠周围脓肿、肛瘘的磁共振诊断与应用价值[J].医学影像学杂志,2011,21(9):1386-1388.[18]阮卫锋,冯庆瑜,李焯洪,等.磁共振成像不同扫描序列诊断肛瘘的价值研究[J].中国CT和MRI杂志,2018,16(7):136-137.

相似文献/References:

[1]雷少晖,张永海.脑氧代谢的影像学测定方法研究[J].医学信息,2018,31(05):38.[doi:10.3969/j.issn.1006-1959.2018.05.015]
　LEI Shao-hui,ZHANG Yong-hai.Imaging Study of Brain Oxygen Metabolism[J].Medical Information,2018,31(24):38.[doi:10.3969/j.issn.1006-1959.2018.05.015]
[2]管海生.膝关节剥脱性骨软骨炎MRI诊断[J].医学信息,2018,31(06):158.[doi:10.3969/j.issn.1006-1959.2018.06.056]
　GUAN Hai-sheng.MRI Diagnosis of Exfoliative Osteochondritis in Knee Joint[J].Medical Information,2018,31(24):158.[doi:10.3969/j.issn.1006-1959.2018.06.056]
[3]刘 钢,李志伟,田 晞,等.磁共振检查对冯·希佩尔·林道综合征诊断的意义[J].医学信息,2018,31(18):145.[doi:10.3969/j.issn.1006-1959.2018.18.047]
　LIU Gang,LI Zhi-wei,TIAN Xi,et al.The Significance of Magnetic Resonance Examination in the Diagnosis of Von Hippel-Lindau Disease[J].Medical Information,2018,31(24):145.[doi:10.3969/j.issn.1006-1959.2018.18.047]
[4]马平平,程宇琪,许秀峰,等.抑郁症脑磁共振成像与抗抑郁治疗临床改善间关系的研究进展[J].医学信息,2018,31(24):31.[doi:10.3969/j.issn.1006-1959.2018.24.009]
　MA Ping-ping,CHENG Yu-qi,XU Xiu-feng,et al.Advances in Research on the Relationship between Brain Magnetic Resonance Imaging and Clinical Improvement of Antidepressant Therapy[J].Medical Information,2018,31(24):31.[doi:10.3969/j.issn.1006-1959.2018.24.009]
[5]刘姗灵,冉 冉,涂 刚.乳腺Paget′s 病诊断与治疗相关研究进展[J].医学信息,2019,32(07):1.[doi:10.3969/j.issn.1006-1959.2019.07.001]
　LIU Shan-ling,RAN Ran,TU Gang.Advances in Research on Diagnosis and Treatment of Paget's Disease in Breast[J].Medical Information,2019,32(24):1.[doi:10.3969/j.issn.1006-1959.2019.07.001]
[6]蔡 彬,黄 伟,储正达,等.直肠腔内超声与相控阵线圈磁共振在直肠癌术前局部分期中的Meta分析[J].医学信息,2019,32(10):70.[doi:10.3969/j.issn.1006-1959.2019.10.024]
　CAI Bin,HUANG Wei,CHU Zheng-da,et al.Meta-analysis of Intra-rectal Ultrasound and Phased-array Magnetic Resonance in the Preoperative Partial Phase of Rectal Cancer[J].Medical Information,2019,32(24):70.[doi:10.3969/j.issn.1006-1959.2019.10.024]
[7]黄亚勇,师毅冰,陈国芳,等.颅内生殖细胞瘤的MRI影像表现及诊断[J].医学信息,2019,32(20):167.[doi:10.3969/j.issn.1006-1959.2019.20.053]
　HUANG Ya-yong,SHI Yi-bing,CHEN Guo-fang,et al.MRI Imaging Findings and Diagnosis of Intracranial Germ Cell Tumor[J].Medical Information,2019,32(24):167.[doi:10.3969/j.issn.1006-1959.2019.20.053]
[8]王召华,李小虎,钱银锋,等.MRI对胰腺导管内乳头状粘液瘤良恶性的诊断价值[J].医学信息,2019,32(14):166.[doi:10.3969/j.issn.1006-1959.2019.14.056]
　WANG Zhao-hua,LI Xiao-hu,QIAN Yin-feng,et al.Diagnostic Value of MRI for Benign and Malignant Intraductal Papillary Myxoma of the Pancreas[J].Medical Information,2019,32(24):166.[doi:10.3969/j.issn.1006-1959.2019.14.056]
[9]刘军莲,戴 娜,杨 迎,等.全脊柱MRI对强直性脊柱炎急性炎症的诊断价值[J].医学信息,2019,32(16):167.[doi:10.3969/j.issn.1006-1959.2019.16.057]
　LIU Jun-lian,DAI Na,YANG Ying,et al.Diagnostic Value of Total Spine MRI in Acute Inflammation of Ankylosing Spondylitis[J].Medical Information,2019,32(24):167.[doi:10.3969/j.issn.1006-1959.2019.16.057]
[10]陈 萍,王培军,石瑛琦,等.安氏III类错颌畸形患者颞下颌关节的MRI检查研究[J].医学信息,2020,33(08):51.[doi:10.3969/j.issn.1006-1959.2020.08.017]
　CHEN Ping,WANG Pei-jun,SHI Ying-qi,et al.MRI Examination of Temporomandibular Joint in Patients with Angle class Ⅲ Malocclusion[J].Medical Information,2020,33(24):51.[doi:10.3969/j.issn.1006-1959.2020.08.017]

更新日期/Last Update: 1900-01-01