MRI conventional sequences combined with DWI and LAVA-enhanced sequence for preoperative diagnosis of anal fistulas
Objective To explore the value of conventional sequences combined with diffusion weighted image(DWI)and liver acceleration volume acquisition(LAVA)-enhanced sequence of 3.0T magnetic resonance imaging(MRI)in preoperative diagnosis of anal fistulas.Methods Seventy-eight patients with anal fistula undergoing surgical treatment in Wenzhou Integrated Traditional and Western Medicine Hospital from May 2021 to June 2023 were included in the study.All patients had an 3.0T MRI examination within 1 week before surgery.With surgical results as the gold standard,the preoperative diagnosis value of conventional sequences,DWI,LAVA enhanced sequence,and the combination of three methods were analyzed.It included that the images of internal openings,main fistula,branch fistula and abscess formation were compared and the consistency between MRI diagnosis and surgical results was evaluated.According to surgical findings patients were divided into three kinds:no-pus(n=14),pus(n=36)and concomitant abscess(n=28).The apparent diffusion coefficient(ADC)of the main fistula for the three were compared.Results There were significant differences in display of internal openings and main fistula among 3 methods alone and their combination(P＜0.05),the conventional sequences and LAVA-enhanced sequence were superior to DWI sequence(P＜0.05);while there were no significant differences in display of branch fistula and abscess formation among three methods(P＞0.05).The MRI Parks'classification of anal fistula was consistent with the surgical results(Kappa=0.769,P＜0.05).The ADC of no-pus was significant different with that of pus and concomitant abscess(P＜0.05),but there was no significant difference in ADC between pus and concomitant abscess(P＞0.05).Conclusion The conventional sequences combined with DWI and LAVA-enhanced sequence of 3.0T magnetic resonance imaging has advantages in displaying the internal openings and main fistula of anal fistula,and can accurately diagnose Parks'classification of anal fistula;and ADC value is helpful to show inflammation,indicating that it may be used as an effective imaging method to assist clinical diagnosis of anal fistula before surgery.
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