磁共振T1增强扫描对复杂性肛瘘诊断及分型的价值

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Abstract Objective: To explore the diagnostic value of contrast-enhanced magnetic resonance T1-weighted imaging in complex anal fistula. Methods: A total of 43 patients with complex anal fistula which confirmed by surgery from the Third Affiliated Hospital of Wenzhou Medical University and the Pingyang People’s Hospital from February 2015 to January 2018 were included in the study. They were underwent T1-weighted imaging (T1WI), T2-weighted imaging with fat saturation (T2WI FS) and T1-weighted imaging with fat saturation (T1WI FS) contrast-enhanced sequences. The display of the three sequences on internal fistula, main canal and branch tube of anal fistula were compared with surgical findings. Results: Among the 43 patients, 67 internal openings, 63 fistulas and 47 fistula branches were found in surgeries. There were 10 internal openings (14.93%), 34 fistulas (53.97%) and 10 fistula branches (21.28%) found by T1WI. There were 52 internal openings (77.61%), 55 fistulas (87.30%) and 40 fistula branches (85.11%) found by T2WI FS. There were 61 internal openings (91.04%), 60 fistulas (95.24%) and 42 fistula branches (89.36%) found by T1WI FS contrast-enhanced scan. Compared with T2WI FS, TIWI FS contrast-enhanced scan had a higher accuracy in showing the internal openings (P<0.05), and there was no statistical difference between the accuracy of showing the fistula and the fistula branch (P>0.05). The accuracy of T1WI FS contrast-enhanced scan was higher than that of T1WI (P<0.05), and the difference was statistically significant. T1WI FS contrast-enhanced scan was highly consistent with surgical results in Parks classification (Kappa=0.926), which was obviously higher than T2WI FS and T1WI sequences (Kappa=0.786, Kappa=0.467). Conclusion: T1WI FS contrast-enhanced sequence can be an important supplement to conventional T2WI FS and T1WI sequences of anal fistula MR examination, especially in the preoperative localization of the internal openings and the classification assessment of complex anal fistula.

Key words： rectal fistula magnetic resonance imaging contrast-enhanced

Received: 31 August 2018

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	XIA Ruike
	SU Miaoguang
	YAN Zhihan.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2019/V49/I6/437

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