CAJ | 학술논문

目的：本研究的目的在于探讨3.0T磁共振LAVA-FLEX动态增强扫描序列在肛瘘诊断及分型中的应用价值。方法术前行普通序列和LAVA-FLEX动态增强扫描序列，统计分析不同扫描序列及动态增强扫描序列各期对肛瘘内口及瘘管的检出率。结果对照手术结果，在肛瘘内口及瘘管显示率上，AX LAVA+C显示率最高,AX LAVA平扫显示率最低，8种序列按序排列依次为AX LAVA+C、COR LAVA+C、AX DWI、SAG LAVA+C、AX T2WI/FS、COR T2WI/FS、SAG T2WI/FS、AX LAVA，总体进行X2检验，P<0.001，差异有显著性意义。在内口及瘘管的显示上，T2WI/FS与LAVA增强序列对比来看，无论从内口的显示来看，还是从瘘管的显示来看，LAVA增强序列都优于T2WI/FS(P分别为0.006、0.005)，差异具有统计学意义。结论 LAVA-FLEX增强MRI扫描检查方法能准确定位各型肛瘘内口、走向，能准确显示与周围组织的关系，分型较为客观准确，是术前诊断各型肛瘘的一种值得推广的扫描方法。
목적：본연구적목적재우탐토3.0T자공진LAVA-FLEX동태증강소묘서렬재항루진단급분형중적응용개치。방법술전행보통서렬화LAVA-FLEX동태증강소묘서렬，통계분석불동소묘서렬급동태증강소묘서렬각기대항루내구급루관적검출솔。결과대조수술결과，재항루내구급루관현시솔상，AX LAVA+C현시솔최고,AX LAVA평소현시솔최저，8충서렬안서배렬의차위AX LAVA+C、COR LAVA+C、AX DWI、SAG LAVA+C、AX T2WI/FS、COR T2WI/FS、SAG T2WI/FS、AX LAVA，총체진행X2검험，P<0.001，차이유현저성의의。재내구급루관적현시상，T2WI/FS여LAVA증강서렬대비래간，무론종내구적현시래간，환시종루관적현시래간，LAVA증강서렬도우우T2WI/FS(P분별위0.006、0.005)，차이구유통계학의의。결론 LAVA-FLEX증강MRI소묘검사방법능준학정위각형항루내구、주향，능준학현시여주위조직적관계，분형교위객관준학，시술전진단각형항루적일충치득추엄적소묘방법。
Objective It was to assess the application value of LAVA-FLEX sequences in determining the type of anal fistula and it was also to study the characteristics in dynamic inhancement phases.Methods 31 patients with surgically proved anal fistula underwent MRI examination.The following sequences were obtained: sagittal T2WI/FS、T2WI/FS axial、T2WI/FS coronary、DWI、LAVA-FLEX, sagittal、axial and coronary LAVA-FLEX + C. Statistical analysis with surgical results was refered as standards.The value of MRI with various sequences in the diagnosis of various types of anal fistulas and their enternal openings was statistically analyzed according to surgical results. SPASS 17.0 software package was used to perform X2 test,t test,analysis of variance and there was statistically significant(P<0.05).Results On the display for internal openings and anal fistula,it showed highest rates reaching up to 88.09% and 87.8% in the AX LAVA-FLEX +C.It showed 8 sequences as follows: AX LAVA+C、COR LAVA+C、AX DWI、SAG LAVA+C、AX T2WI/FS、COR T2WI/FS、SAG T2WI/FS、AX LAVA.It performed X2 test, the results of interal openings: X2=28.886,P1=0.000, P1<0.001,the results of anal fistula: X2=42.352,P1=0.000, P1<0.001, The difference was statistically significant. LAVA-FLEX inhanced sequence was better than T2WI/FS(P=0.006、0.005), there was statistically significant difference.It was compared with 6 phases ,contrast noise ratio showed from high to low equilibrium phase、venous phase、late arterial phase、coronal phase、early arteral phase、sagittal phase、plain phase.Conclusion It showed highest rate in AX LAVA+C for kinds of sequences in MRI for ana fistula. It showed highest for contrast noise ratio in the equilibrium phase.