高分辨率MRI-T2加权成像联合扩散加权成像对肛瘘及其活动性的评价

摘要

目的 评价高分辨率MRI脂肪抑制T2加权成像(T2WI)联合扩散加权成像(DWI)在肛瘘及其活动性中的应用价值.方法 对2016年1月至2017年11月已行高分辨率MRI扫描的59例肛瘘患者的临床及影像学资料进行分析.根据临床及手术结果将瘘管分为活动性(PIA)和非活动性(NIA)并测量瘘管的ADC值.结果59例患者经手术证实共71条瘘管和62个内口.PIA瘘管和NIA瘘管间的ADC值存在差异(P=0.001),ADC最佳阈值为1.214.高分辨率MRI脂肪抑制T2WI、DWI及T2WI联合DWI对瘘管及内口的敏感性分别为80.28%(57/71)、83.10%(59/71)、95.77%(68/71)及82.26%(51/62)、83.87%(52/62)、96.77%(60/62).结论 MRI-DWI在评价肛瘘的活动性中具有重要作用,高分辨率MRI脂肪抑制T2WI联合DWI对瘘管和内口的敏感性最高.%Objective To evaluate the application value of high resolution MRI fat suppression T2WI combined with DWI in anal fistula and its activity. Methods We analyzed the clinical data and MRI findings of 59 patients who received high resolution MRI from January 2016 to November 2017. According to the clinical and surgical results,anal fistulas were divided into positive inflammatory activity(PIA)and negative inflammatory activity(NIA). ADC values of anal fistula were measured and the optimal cut-off of ADC values were calculated. Results 59 patients with 71 anal fistulas and 62 internal openings confirmed by surgical results.ADC values were differenct between PIA and NIA anal fistulas(P = 0.001) and the optimal cut-off of ADC value were 1.214. The sensitivity of high resolution MRI fat suppression T2WI,DWI and T2WI combined with DWI for detecting anal fistula and internal opening were 80.28%(57/71),83.10%(59/71),95.77%(68/71) and 82.26%(51/62), 83.87%(52/62),96.77%(60/62),respectively. Conclusion MRI-DWI is very important for evaluating the activities of anal fistula and thigh resolution MRI fat suppression T2WI combined with DWI has the highest sensitivity for detecting anal fistula and internal opening.