CAJ | 학술논문

目的探讨MRI与造影检查在先天性肛门直肠畸形(congenital anorectal malformations,CARM)瘘管诊断中的临床应用价值并将两者进行对照研究.方法回顾性分析我院2008年5月至2012年12月经手术治疗并确诊的先天性肛门直肠畸形伴发瘘管患儿26例,男17例,女9例,年龄1d至36个月.患儿术前均行MRI及造影检查.结果 CARM伴发瘘管26例中,高位肛门闭锁型CARM 11例,其中会阴瘘7例,膀胱瘘2例,尿道瘘1例,阴道瘘1例;中位肛门闭锁型CARM 9例,其中会阴瘘5例,尿道瘘3例,阴道瘘1例;低位肛门闭锁型CARM6例,其中会阴瘘5例,阴囊根部体表瘘1例.MRI诊断瘘管的准确率为57.96％(15/26),造影检查诊断瘘管的准确率为88.46％(23/26),两者之间经统计学处理有显著性差异(x2=9.65,P＜0.01).结论 MRI与造影检查在诊断CARM瘘管方面具有很高的临床应用价值.MRI诊断瘘管的准确率明显低于造影检查,两者相结合可以有效的提高瘘管诊断准确率,减少患儿X线辐射剂量及创伤,优化影像学检查方法.
목적 탐토MRI여조영검사재선천성항문직장기형(congenital anorectal malformations,CARM)루관진단중적림상응용개치병장량자진행대조연구.방법 회고성분석아원2008년5월지2012년12월경수술치료병학진적선천성항문직장기형반발루관환인26례,남17례,녀9례,년령1d지36개월.환인술전균행MRI급조영검사.결과 CARM반발루관26례중,고위항문폐쇄형CARM 11례,기중회음루7례,방광루2례,뇨도루1례,음도루1례;중위항문폐쇄형CARM 9례,기중회음루5례,뇨도루3례,음도루1례;저위항문폐쇄형CARM6례,기중회음루5례,음낭근부체표루1례.MRI진단루관적준학솔위57.96％(15/26),조영검사진단루관적준학솔위88.46％(23/26),량자지간경통계학처리유현저성차이(x2=9.65,P＜0.01).결론 MRI여조영검사재진단CARM루관방면구유흔고적림상응용개치.MRI진단루관적준학솔명현저우조영검사,량자상결합가이유효적제고루관진단준학솔,감소환인X선복사제량급창상,우화영상학검사방법.
Objective To explore the clinical values of magnetic resonance imaging (MRI) and radiography examination for congenital anorectal malformation (CARM).Methods A total of 26 cases with surgically proved CARM with fistula from May 2008 to December 2012 at our hospital were reviewed.There were 17 males and 9 females with an age range of 1 day to 36 months.MRI and radiography were performed.Results Among them,there were high imperforate anus (n =11),perineal fistula (n =7),bladder fistula (n =2),urethral fistula (n =1),vaginal fistula (n =1) ; median imperforate anus (n =9),perineal fistula (n =5),urethral fistula (n =3),vaginal fistula (n =1) ; low imperforate anus (n =6),perineal fistula (n =5) and scrotal root surface fistula (n =1).The MRI diagnostic accuracy rate was 57.96 ％ (15/26) and radiographic diagnostic accuracy rate 88.46 ％ (23/26).And there were statistically significant differences (X2 =9.65,P＜0.01).Conclusions MRI and radiography have high clinical diagnostic values for CARM with fistula.Diagnostic accuracy of MRI is significantly lower than that of fistula angiography.And a combination of both may effectively improve the diagnostic accuracy of fistula,reduce radiation dose,lessen trauma and optimize imaging modalities.