摘要
目的探讨磁共振T_2WI脂肪抑制（FS）序列、质子加权预饱和脂肪抑制（PDWI PFS）序列与增强T_1WI FS序列对肛瘘瘘管诊断价值的差异。方法 68例经手术病理证实为肛瘘的患者术前均行MRI扫描。以手术结果为标准,比较分析横断位三种不同序列对肛瘘瘘管形态特征和走形的显示价值。结果主瘘管（包括脓肿）正确显示率分别为T_2WI FS 96.7%、PDWI PFS 97.8%、增强T_1WI FS 97.8%,差别无统计学意义（P〉0.05）;但任意两种序列对其显示清晰度的评分均有高度统计学差异（P〈0.05）;但任意两种序列对其显示清晰度的评分均有统计学差异（P〈0.05）,从优至劣排序为增强T_1WI FS序列、PDWI PFS序列、T_2WI FS序列。按照Parks分型,分型符合率为T_2WI FS 86.5%、PDWI PFS 93.3%、增强T_1WI FS 93.3%,T_2WI FS序列明显低于PDWI PFS与增强T_1WI FS序列,差别有统计学意义（P〈0.05）,PDWI PFS与增强T_1WI FS序列无明显差别;但任意两种序列对瘘管与肛门括约肌的关系显示清晰度的评分均有统计学差异（P〈0.05）,增强T_1WI FS序列最好。结论对于主瘘管（包括脓肿）、瘘管分支及多发细小瘘管三种扫描序列均可以准确显示,但增强T_1WI FS序列可以提供更丰富的细节;在分型上,PDWI PFS与增强T_1WI FS序列均优于T_2WI FS序列,但在瘘管与肛门括约肌关系显示上,增强T_1WI FS序列可以提供更丰富的细节。
Objective To explore the comparative value of MR T_2WI FS sequence,PDWI PFS sequence and T_1WI FS enhanced sequence in evaluating the morphological features of anal fistula. Methods 68 patients with pathology proven perianal fistula received MR scans before surgery. According to surgical results,three sequences with the correct diagnostic rate of anal fistula＇s morphology were compared. Results On the demonstration of anal fistula＇s primary tracts（ including abscesses）,the accuracy of MRI was 96. 7% for T_2 WI FS sequence,97. 8% for PDWI PFS sequence and 97. 8% for T_1WI FS enhanced sequence. There was no statistical difference among the sequences（ P〈0. 05）. T_1WI FS enhanced sequence provided the best and the clearest demonstration of the fistulas since there were significant statistical differences among them（ P〈0. 001）. On the demonstration of anal fistula＇s secondary and multiple small tracts,the accuracy of MRI was 95. 7% for all three sequences. There was no statistical difference among them（ P〈0. 05）. T_1 WI FS enhanced sequence also provided the best and clearest view since there were significant statistical differences among them（ P〈0. 05）. On the diagnosis of anal fistula＇s type with the Parks classifications,the accuracy of T_2WI FS sequence was lower than the other two sequences. There was a statistical difference among them（ P〈0. 05）. T_1WI FS enhanced sequence provided the best and clearest view of the relationships between fistula and anal sphincter since there were significant statistical differences among them（ P〈0. 05）. Conclusion On the demonstration of anal fistula＇s primary tracts（ including abscesses）,secondary and multiple small tracts,three sequences can all accurately clarify,but T_1WI FS enhanced sequence can provide more details. On the demonstration of anal fistula＇s type,both T_1WI FS enhanced sequence and PDWI PFS sequence do better than T_2WI FS sequence. For the relationship between fistula and anal sphincter,T_1WI FS enhanced sequence can offer more detail.
出处
《临床放射学杂志》
CSCD
北大核心
2018年第2期289-293,共5页
Journal of Clinical Radiology
基金
上海市卫生计生委课题(编号:20154Y0118)
