3．0T MR不同扫描序列对肛瘘的诊断.pdfVIP

第45卷第l2期 山 东 大 学 学 报 (医 学 版) Vo1．45 No．12 2OO7年l2月 JOURNAL OF SHANDONG UNIVERSITY(HEALTH SCIENCES) Dec．姗 文章编号：1671—7554(2007)12—1261—03 3．0T MR不同扫描序列对肛瘘的诊断 李莹 ，李传福 ，戴勇 ，孟祥水。，康笑水 (山东大学齐鲁医院1．放射科；2．普外科，济南250012) 摘要：目的 比较不同磁共振成像(MR)序列对肛瘘病变的显示，探讨其在临床诊治中的应用价值。方 法 收集l5例临床疑诊为肛瘘的患者，于术前行MR扫描，MR扫描序列包括矢状T (SAG WI)、冠状 脂肪抑制序列(COR T2 FS)，轴位FSE T1 (Ax 11l )，轴位VRFSET~ (Ax T2 )，轴位T2脂肪抑制序列(AX T2 rs)和动态增强(HE)，检查结果与手术结果对照。结果 15例患者术中共发现内口16个，瘘管l4个。 根据John Morris等的分类方法，l5例患者中，l级肛瘘3例，2级肛瘘6例，3级肛瘘3例，4级肛瘘2例，5级 肛瘘l例，其中2例为单纯肛周脓肿。在内口的显示率上，动态增强扫描高于其他扫描序列，但与轴位 脂 肪抑制序列相比无统计学意义(P0．05)。在瘘管的显示率上，动态增强扫描亦高于其他扫描序列，但仅与 轴位 序列相比有统计学意义(P0．05)。结论 动态增强扫描结合冠状面扫描可以较好地显示肛瘘 病变，能够为外科手术方式的选择提供较详尽的影像资料。 关键词：磁共振成像；肛瘘 中图分类号：R445．2 文献标志码：A Diagnosis of perianal fistula with different MR sequences at 3．0 Tesla LI Ying ，LI Chuan—fu ，DAI Yong2， MENG Xiang．shui ，KANG Xiao—shui (1．Imaging Center；2．General Surgery Department，Qilu Hospital，Shandong University， Jinan 250012，China) Abstract：Objective To explore the clinical value of different MR sequences in the diagnosis of pefianal fistula． Methods MR1 was performed on fifteen cases of clinically suspected pefianal fistula．The MR pulse sequences included sagittal T2 WI(SAG T2 WI)，coronal T2 W1 with fat suppression(COR T2 FS)，axial T1 (Ax TlWI)，axial T2Ⅵ(Ax T2WI)，axial T2W1 with fat suppression(Ax T2 FS)and dynamic contrast enhancement(DCE)．The MR findings were c(IⅡlpaI副 with the surgical results．Results 16 internal opening and 14 tracks were found in 15 cases．Based on John Morris S study，3 cases were gradel，6 cases were grade2，3 cases were grade3，2 cases were grade 4，and 1 case was grade 5．Only 2 cases had a pefianal abscess．The internal opening display rate of the DCE imaging Was much higher