摘要
目的 比较MRI T1WI+FST2WI、DWI、CE-FST1WI、T1WI+FST2WI联合DWI四组序列对肛瘘结构显示的优劣,探讨何种序列可作为无创的检查序列替代CE-FST1WI.方法 选取 46 例手术证实为肛瘘患者的资料,术前实施 MRI T1WI+FST2WI、DWI、CE-FST1WI、T1WI+FST2WI联合DWI序列扫描,以手术结果为金标准,分析T1WI+FST2WI、DWI、CE-FST1WI、T1WI+FST2WI联合DWI对内口、主瘘管、分瘘管的显示情况.结果 46 例肛瘘患者手术发现主瘘管 58 支,共57 个内口,其中有 2 支主瘘管同时开口于一个内口;15 例有分瘘管共 25 支,15 例伴脓肿形成.T1WI+FST2WI联合DWI及CE-FST1WI都可较好地显示瘘管内口,与手术结果比较差异无统计学意义(P>0.05);T1WI+FST2WI联合DWI、CE-FST1WI、T1WI+FST2WI均可较好地显示主瘘管,与手术结果比较差异无统计学意义(P>0.05);四组序列都可较好的显示分瘘管,与手术结果比较差异无统计学意义(P>0.05).结论 不同MRI序列应用于肛瘘诊断时,T1WI+FST2WI联合DWI和CE-FST1WI序列均能很好地显示内口、主瘘管及分瘘管,且两者之间并无优劣之分.T1WI+FST2WI联合DWI序列可作为无创性评估肛瘘形态的最佳检查序列.
Abstract
Objective Four MRI sequences of T1WI+FST2WI,DWI,CE-FST1WI and T1WI+FST2WI combined with DWI were analyzed and recorded for the diagnosis of anal fistula,and the advantages and disadvantages of the four sequences for the display of anal fistula structures were compared to explore a noninvasive MRI examination sequence to instead of CE-FST1WI.Methods Clinical and MRI data of 46 patients with anal fistula were collected and collated,and the four sequences of T1WI+FST2WI combined with DWI,T1WI+FST2WI,DWI,and CE-FST1WI were counted to show the display of internal orifice,main fistulas,branch fistulas,using surgical pathology results as the gold standard.Results 58 main fistulas with 57 internal orifices were found in 46 patients,of which 2 main fistulas were opened in one internal orifice,15 cases presented with 25 branch fistu-las and 15 cases with abscess.And the results showed that T1WI+FST2WI+DWI and CE-FST1WI could show the internal orifice of the fistula better,which were not statistically different from the surgical results(P＞0.05)On the display of the main fistula,T1WI+FST2WI+DWI,CE-FST1WI,and T1WI+FST2WI could be well displayed,which were not significantly different from the surgical results(P＞0.05).Four groups of MRI sequences showed the branch fistula well and with no statistically significant differ-ences from the surgical results(P＞0.05).Conclusion The T1WI+FST2WI+DWI and CE-FST1WI sequences can show the inter-nal orifice,main fistula and branch fistula well,and there is no superiority between them.
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