MRI增强检查在复杂性肛瘘诊断中的价值研究

来源:用户上传      作者:许辉 孔德伟

　　[摘要]目的通^核磁共振（MRI）检查与手术检查结果对照研究，评价增强 MRI 在诊断复杂性肛瘘的影像特征、优势及不足。方法选取2020年12月至2021年10月上海中医药大学附属龙华医院31例复杂性肛瘘住院患者行增强3.0 T MRI 检查，得到瘘管类型、数目、形态、与括约肌的关系、内瘘口位置等诊断信息，并与手术结果比较。结果复杂性肛瘘患者的 MRI 检查与手术探查结果在内瘘口数目和位置的诊断吻合度中等（ P <0.05），MRI 在复杂性肛瘘的内瘘口信息诊断的灵敏度为100.0%，特异度为78.6%，误诊率为21.4%，漏诊率为0;MRI 与手术探查结果在主瘘管数目的诊断有较高的吻合度（ P <0.05），两种方法间差异无统计学意义（P>0.05）。MRI 与手术探查对主瘘管分型的诊断、支瘘管数目和分型的诊断具有中等吻合度（P<0.05）。手术探查对支瘘管的分类优于 MRI（ P <0.05）。结论 MRI 在复杂性肛瘘的诊断中具有很高的诊断价值，在主瘘管的诊断与手术检查结果一致，对于内瘘口及支瘘管显示及诊断的能力有待于加强。
　　[关键词]核磁共振;复杂性肛瘘;增强检查;瘘管类型
　　[中图分类号] R445; R657.1+6[文献标识码] A [文章编号]2095-0616（2022）15-0142-05
　　The value of enhanced MRI examination in the diagnosis of complex anal fistulas
　　XUHuiKONGDewei
　　1. Department of Radiology， Shanghai Qingpu District Hospital of Traditional Chinese Medicine， Shanghai 201799， China;2. Department of Radiology， Longhua Hospital of Shanghai University ofTCM， Shanghai 200032， China [Abstract] Objective To evaluate the imaging features， advantages and shortcomings of enhanced MRI in the diagnosis of complex anal fistulas through a controlled study of MRI examination results versus surgical exploration findings. Methods A total of 31 inpatients with complex anal fistulas from December 2020 to October 2021 at Longhua Hospital of Shanghai University of TCM were selected to undergo enhanced 3.0 T MRI examination， and diagnostic information such as fistula type， number， morphology， relationship with the sphincter muscle， and location of the internal orifice were obtained and compared with the surgical exploration findings. Results A moderate coincidence degree was found between MRI examination results and surgical exploration findings in the diagnosis of the number and location of internal orifice in patients with complex anal fistulas （P <0.05）. The sensitivity was 100.0%， specificity was 78.6%， rate of misdiagnosis was 21.4%， and rate of missed diagnosis was 0 for MRI in the diagnosis of complex anal fistulas. There was a high coincidence degree between MRI examination results and surgical exploration findings in the diagnosis of the number and location of the main fistula （P <0.05）， and there was no statistically significant difference between the two diagnostic methods （P >0.05）. There was a moderate coincidence degree between the MRI examination and surgical exploration methods in the diagnosis of the main fistula classification and the number and classification of the sub-fistula （P <0.05）. Surgical exploration was superior to MRI examination in the diagnosis of the sub- fistula classification （P <0.05）. Conclusion MRI has high diagnostic value in the diagnosis of complex anal fistulas， and its diagnostic results in the main fistula are in agreement with the surgical exploration findings， but its ability to show and diagnose the internal orifice and sub-fistula needs to be improved.

nlc202209151536

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