CAJ | 학술논문

目的：探讨MSCT直肠填塞瘘管造影平扫、增强扫描及三维重建技术对肛瘘病变临床诊断价值。方法对86例临床疑诊肛瘘病变的患者使用16层螺旋CT扫描及直肠填塞瘘管造影检查，并进行多平面重建(MPR)及3D重建。并将术前影像诊断资料和术后随访结果进行对比。结果86例肛瘘MSCT准确显示瘘管内口位置81例，5例未发现肛瘘内口，与手术符合率为94.2%；84例显示原发瘘管、部分分支及瘘管与肛门括约肌等周围结构的关系，与手术结果符合率为93.9%，脓腔的检出率100%；MSCT后处理技术可较准确显示瘘管的具体形态、位置-走行及其与肛管或直肠的关系等特点。结论 MSCT平扫、增强扫描并结合直肠填塞瘘管造影是一种有效而可靠的术前评估瘘管尤其是对复杂肛瘘的检查方法，可为手术方式的选择提供详尽有效影像资料依据。
목적：탐토MSCT직장전새루관조영평소、증강소묘급삼유중건기술대항루병변림상진단개치。방법대86례림상의진항루병변적환자사용16층라선CT소묘급직장전새루관조영검사，병진행다평면중건(MPR)급3D중건。병장술전영상진단자료화술후수방결과진행대비。결과86례항루MSCT준학현시루관내구위치81례，5례미발현항루내구，여수술부합솔위94.2%；84례현시원발루관、부분분지급루관여항문괄약기등주위결구적관계，여수술결과부합솔위93.9%，농강적검출솔100%；MSCT후처리기술가교준학현시루관적구체형태、위치-주행급기여항관혹직장적관계등특점。결론 MSCT평소、증강소묘병결합직장전새루관조영시일충유효이가고적술전평고루관우기시대복잡항루적검사방법，가위수술방식적선택제공상진유효영상자료의거。
Objective To explore the clinical value of MSCT fistulography enhancement scanning and three dimensional reconstruction in the diagnosis of anal fistula. Methods Eighty-six cases with clinically suspected anal fistula were included in the study. The patients were underwent 16 multi-detector spiral CT scanning, fistulography, MPR and 3D reconstruction. The preoperative diagnostic information was compared to the postoperative follow-up results. Results Interal position were found in 81 cases, and the detection rate was 94.2%. 84 cases showed the primary fistula, part of the branch and the relationship between fistula and surrounding structures such as anal sphincter. The coincidence rate was 93.9%, and the detection rate of abscess was 100%. The MSCT post-processing technology can show the fistula's specific form, position and the relationship between anal tube and surrounding structures. Conclusion MSCT enhancement scanning and fistulography is a reliably preoperative assessment to fistula, especially a method of examination to complex fistula. It could supply effective and detailed information for the choose of operation methods.