实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2015年
8期
83-85,89
,共4页
邵继满%陈志坚%万小玲%卜军%肖慧荣
邵繼滿%陳誌堅%萬小玲%蔔軍%肖慧榮
소계만%진지견%만소령%복군%초혜영
肛瘘%钆增强%三维损毁梯度回波%磁共振成像%诊断
肛瘺%釓增彊%三維損燬梯度迴波%磁共振成像%診斷
항루%구증강%삼유손훼제도회파%자공진성상%진단
anal fistula%gadolinium-enhanced%three-dimensional spoiled gradient recalled%magnetic resonance imaging%diagnosis
目的：通过钆增强三维损毁梯度回波（3D-SPGR）序列与其他常规 MRI序列比较，评估增强3D-SPGR序列在肛瘘诊断中的临床应用价值。方法对97例肛瘘患者术前均行 MRI平扫及增强扫描，序列包括矢状位 T2加权成像（Sag T2WI）、冠状位T2WI抑脂（Cor T2WI FS）、横断位 T2WI（Ax T2WI）、横断位 T2WI抑脂（Ax T2WI FS）和钆增强三维损毁梯度回波（3D-SPGR）。评估和比较 MRI各序列显示的瘘管、内口、瘘管分支及脓腔。结果97例患者中内口和主瘘管117个，支瘘管143个。1级肛瘘12例，2级肛瘘11例，3级肛瘘11例，4级肛瘘39例，5级肛瘘24例。MRI各序列结果显示，97例患者3D-SPGR显示内口和瘘管、支瘘管的阳性率均明显高于 Sag T2WI、AX T2WI、AX T2WI FS、Cor T2WI及Cor T2WI FS（均P＜0．05）。结论钆增强3D-SPGR序列可提高肛瘘诊断的准确率，能够为外科手术方式的选择提供较详尽的影像资料。
目的：通過釓增彊三維損燬梯度迴波（3D-SPGR）序列與其他常規 MRI序列比較，評估增彊3D-SPGR序列在肛瘺診斷中的臨床應用價值。方法對97例肛瘺患者術前均行 MRI平掃及增彊掃描，序列包括矢狀位 T2加權成像（Sag T2WI）、冠狀位T2WI抑脂（Cor T2WI FS）、橫斷位 T2WI（Ax T2WI）、橫斷位 T2WI抑脂（Ax T2WI FS）和釓增彊三維損燬梯度迴波（3D-SPGR）。評估和比較 MRI各序列顯示的瘺管、內口、瘺管分支及膿腔。結果97例患者中內口和主瘺管117箇，支瘺管143箇。1級肛瘺12例，2級肛瘺11例，3級肛瘺11例，4級肛瘺39例，5級肛瘺24例。MRI各序列結果顯示，97例患者3D-SPGR顯示內口和瘺管、支瘺管的暘性率均明顯高于 Sag T2WI、AX T2WI、AX T2WI FS、Cor T2WI及Cor T2WI FS（均P＜0．05）。結論釓增彊3D-SPGR序列可提高肛瘺診斷的準確率，能夠為外科手術方式的選擇提供較詳儘的影像資料。
목적：통과구증강삼유손훼제도회파（3D-SPGR）서렬여기타상규 MRI서렬비교，평고증강3D-SPGR서렬재항루진단중적림상응용개치。방법대97례항루환자술전균행 MRI평소급증강소묘，서렬포괄시상위 T2가권성상（Sag T2WI）、관상위T2WI억지（Cor T2WI FS）、횡단위 T2WI（Ax T2WI）、횡단위 T2WI억지（Ax T2WI FS）화구증강삼유손훼제도회파（3D-SPGR）。평고화비교 MRI각서렬현시적루관、내구、루관분지급농강。결과97례환자중내구화주루관117개，지루관143개。1급항루12례，2급항루11례，3급항루11례，4급항루39례，5급항루24례。MRI각서렬결과현시，97례환자3D-SPGR현시내구화루관、지루관적양성솔균명현고우 Sag T2WI、AX T2WI、AX T2WI FS、Cor T2WI급Cor T2WI FS（균P＜0．05）。결론구증강3D-SPGR서렬가제고항루진단적준학솔，능구위외과수술방식적선택제공교상진적영상자료。
Objective To assess the clinical value of gadolinium-enhanced three dimension-spoiled gradient(3D-SPGR)sequence in the diagnosis of anal fistula through comparing with oth-er conventional MRI sequences.Methods Unenhanced and contrast-enhanced MRI were per-formed in 9 7 patients with anal fistula.The MRI sequences included sagittal T2 WI(Sag T2 WI), coronal T2 WI with fat suppression(Cor T2 WI FS),axial T2 WI(Ax T2 WI),axial T2 WI with fat suppression(Ax T2WI FS),and 3D-SPGR.MRI manifestations of fistula,endostoma,fistula branch and vomica were compared with the operation results.Results There were 1 1 7 endosto-mas and main fistulas and 143 fistula branches in the 97 patients.Among these patients,12 had grade 1 anal fistula,1 1 had grade 2 anal fistula,1 1 had grade 3 anal fistula,3 9 had grade 4 anal fis-tula,and 24 had grade 5 anal fistula.Compared with Sag T2WI,AX T2WI,AX T2WI FS,Cor T2WI or Cor T2WI FS,3D-SPGR showed a significant increase in the positive rates of endosto-ma,main fistula and fistula branch(P<0.05).Conclusion Gadolinium-enhanced 3D-SPGR im-proves the diagnosis accuracy of anal fistula,and provides detailed image data for the choice of surgical approach.
