首页|MRI-3D模型在湿热下注型经括约肌肛瘘个性化诊疗中的应用研究

MRI-3D模型在湿热下注型经括约肌肛瘘个性化诊疗中的应用研究

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目的:探讨核磁共振成像(MRI)-3D模型在湿热下注型经括约肌肛瘘中的应用,以便更好地理解瘘管形态、走形及和括约肌间的关系,为肛瘘的诊疗提供个性化辅助手段。方法:运用病例对照研究的方法,选取2020年1月至2023年6月经丹阳市中医院临床及手术证实的74例湿热下注型经括约肌肛瘘患者,均进行MRI扫描,其中37例行3D建模作为观察组,37例未行3D建模作为对照组。记录两组患者肛瘘内口及瘘管数量、是否伴发脓肿,并统计分析肛瘘内口、瘘管及脓肿诊断灵敏度。根据两组检查结果设计手术方案,比较两组患者瘘管愈合情况、手术时间、临床和放射学愈合时间。结果:两组患者肛瘘内口、瘘管以及伴发脓肿数量手术及MRI检查结果、肛瘘内口、瘘管及脓肿诊断灵敏度比较,差异无统计学意义(P>0。05)。两组患者临床未愈合率、放射学未愈合率、愈合率比较,差异无统计学意义(P>0。05)。两组 12 例未愈合的患者中 8 例伴发脓肿,其中 5 例临床未愈合的患者均伴发脓肿,7 例放射学未愈合的患者中 3 例伴发脓肿(3 例中对照组 1 例,观察组 2 例)。观察组患者平均手术时间短于对照组,差异具有统计学意义(P<0。05),两组患者平均临床和放射学愈合时间比较,差异无统计学意义(P>0。05)。观察组 3D建模时间平均为(33。59±6。73)min。结论:MRI-3D模型对湿热下注型经括约肌肛瘘的内口、瘘管及脓肿的诊断具有较高灵敏度,MRI-3D模型的个性化辅助诊疗有助于缩短肛瘘患者的平均手术时间。
Application of MRI-3D Model in Personalized Diagnosis and Treatment of Syndrome of Dampness-heat Diffusing Downward Transsphincter Anal Fistula
Objective To discuss the application of magnetic resonance imaging(MRI)-3D model in syndrome of dampness-heat diffusing downward transsphincter anal fistula,in order to better understand anal fistula's morphology,trend and the relationship with the sphincter and provide personalized auxiliary diagnosis and treatment.Methods A case-control study was conducted,74 patients with syndrome of dampness-heat diffusing downward transsphincter anal fistula were confirmed by operation at Danyang Hospital of Traditional Chinese Medicine from January 2020 to June 2023,all had undergone MRI scans,among them,37 cases underwent 3D modeling as the observation group and 37 cases did not undergo 3D modeling as the control group.The number of internal orifices,fistulas and the presence or absence of abscesses in two groups were recorded,the diagnostic sensitivity were calculated and analyzed.The surgical plan was designed according to the MRI results of the two groups,the fistula helaing status,surgical time,clinical and radiologic healing time between the two groups were compared.Results Operation and MRI examination results of the number of internal orifices,fistulas and the presence of abscesses and the sensitivities to detect them of two groups were compared,there were no statistically significant difference between the two groups(P>0.05).There were no statistically significant difference in clinical unhealing rate,radiologic unhealing rate and healing rate between the two groups(P>0.05).Among two groups of 12 unhealing patients,8 were accompanied by abscess,of which 5 patients with clinical unhealing were all accompanied by abscesses,3 of 7 patients with radiologic unhealing were accompanied by abscesses(1 of the 3 patients was in the control group,2 cases in the observation group).The mean operation time of the patients in the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the mean clinical and radiologic healing time between the two groups(P<0.05).The mean 3D modeling time of the observation group was(33.59±6.73)minutes.Conclusion The MRI-3D model has high sensitivity in the diagnosis of the internal orifice,fistula and abscess of the syndrome of dampness-heat diffusing downward transsphincter anal fistula,and the personalized auxiliary diagnosis and treatment of MRI-3D model is helpful to shorten the surgical time.

Anal fistulaTranssphincter typeSyndrome of dampness-heat diffusing downwardMagnetic resonance imaging3D modeling

杨来华、洪亮、祖大报、符昕、孙志远

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丹阳市中医院,江苏 丹阳 212300

东部战区总医院,江苏 南京 210002

肛瘘 经括约肌型 湿热下注型 核磁共振成像 3D建模

丹阳市重点研发计划(社会发展)项目

SSF202210

2024

深圳中西医结合杂志
深圳市中西医结合临床研究所

深圳中西医结合杂志

影响因子:0.692
ISSN:1007-0893
年,卷(期):2024.34(8)
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