CAJ | 학술논문

目的：评价磁共振扩散加权成像序列(DWI)结合常规序列对复杂性肛瘘显示的准确性，探讨DWI在复杂性肛瘘中的应用价值。方法30例经手术证实的复杂性肛瘘患者术前均行MRI检查，扫描序列包括常规序列横轴位T1WI、T2WI、T2WI脂肪抑制，冠状位、矢状位T2WI脂肪抑制及DWI，以手术结果为标准，分别观察并比较评估常规扫描序列和常规扫描序列+DWI对肛瘘瘘管、内口及脓肿的显示情况。结果30例肛瘘患者，MR常规扫描序列诊断内口灵敏度为81.4%(38/43)，阳性预测值为89.7%(35/39)；瘘管灵敏度为90.2%(37/41)，阳性预测值86.0%(37/43)；脓肿灵敏度91.6%(11/12)，阳性预测值100%(11/11)；常规序列+DWI诊断内口灵敏度95.3%(41/43)，阳性预测值95.3%(41/43)，瘘管灵敏度92.7%(38/41)，阳性预测值97.4%(38/39)，脓肿灵敏度100%(12/12)，阳性预测值100%(12/12),两种诊断方法比较，常规序列+DWI对肛瘘的诊断效果要优于常规序列，其中对内口的显示灵敏度有统计学差异(P<0.05)。结论磁共振常规序列+DWI显示肛瘘内口、瘘管及脓肿具有较高的临床应用价值，可以作为外科手术前的常规检查。
목적：평개자공진확산가권성상서렬(DWI)결합상규서렬대복잡성항루현시적준학성，탐토DWI재복잡성항루중적응용개치。방법30례경수술증실적복잡성항루환자술전균행MRI검사，소묘서렬포괄상규서렬횡축위T1WI、T2WI、T2WI지방억제，관상위、시상위T2WI지방억제급DWI，이수술결과위표준，분별관찰병비교평고상규소묘서렬화상규소묘서렬+DWI대항루루관、내구급농종적현시정황。결과30례항루환자，MR상규소묘서렬진단내구령민도위81.4%(38/43)，양성예측치위89.7%(35/39)；루관령민도위90.2%(37/41)，양성예측치86.0%(37/43)；농종령민도91.6%(11/12)，양성예측치100%(11/11)；상규서렬+DWI진단내구령민도95.3%(41/43)，양성예측치95.3%(41/43)，루관령민도92.7%(38/41)，양성예측치97.4%(38/39)，농종령민도100%(12/12)，양성예측치100%(12/12),량충진단방법비교，상규서렬+DWI대항루적진단효과요우우상규서렬，기중대내구적현시령민도유통계학차이(P<0.05)。결론자공진상규서렬+DWI현시항루내구、루관급농종구유교고적림상응용개치，가이작위외과수술전적상규검사。
ObjectiveTo evaluate the accuracy of diffusion weighted imaging (DWI) combined with generic sequence in complex anal fistula and to discuss the application value of DWI in complex anal fistula.Methods 30 cases of patients who were confirmed with complex anal fistula were given MRI before operation. Scan sequences included axial T1WI, T2WI and fat sequence T2WI, and coronal and sagittal fat sequence T2WI and DWI. With surgical results as the standard, conventional sequences and conventional sequences + DWI were compared for anal fistula, internal opening and abscess.Results For 30 cases of patients with anal fistula, sensitivity and positive predict value of MR conventional sequences were 81.4%(38/43) and 89.7%(35/39) respectively for internal opening; 90.2%(37/41) and 86.0%(37/43) for anal fistula; 91.6%(11/12) and 100%(11/11) for abscess. Sensitivity and positive predict value of MR conventional sequences + DWI were 95.3%(41/43) and 95.3%(41/43) for internal opening; 92.7%(38/41) and 97.4% (38/39) for anal fistula; 100%(12/12) and 100%(12/12) for abscess. In comparison of two kinds of diagnostic methods, conventional sequences + DWI had better diagnostic results on anal fistula than conventional sequences, and the sensitivity for internal opening was of statistical difference (P<0.05).Conclusions MRI + DWI shows higher clinical application value for internal opening and canal of anal fistula and abscess, which can be used as a conventional preoperative examination.