多模态磁共振序列对肛瘘的诊断效能

Multimodal magnetic resonance imaging sequences for diagnosis of anal fistula

摘要:

目的 探讨多模态下磁共振对肛瘘的诊断效能。方法 选取2018年1月至2022年8月武汉科技大学附属孝感医院收治的73例肛瘘患者进行回顾性分析。肛瘘患者术前均行磁共振平扫+增强检查。以手术结果为参照，分析不同序列之间对肛瘘的诊断效能。结果 临床分型与Parks分型和手术结果相比，Kappa值分别为0.815、0.856，具有较好一致性；在瘘口与分支中，手术结果为内口98个，准确率93.33%，瘘管126条，准确率94.74%。在多模态序列下，较单个序列对肛瘘的内口与瘘管显示方面诊断差异有统计学意义（P<0.05）。结论 多模态下磁共振对肛瘘的诊断效能更佳，尤其是对细小内口及瘘管的细小分支显示更好，能为术前评估提供可靠依据，能较好帮助临床为肛瘘患者解决病灶。

Abstract:

Objective To investigate the diagnostic efficacy of magnetic resonance imaging (MRI) in anal fistula under multimodal conditions.Methods A retrospective analysis was conducted on 73 anal fistula patients admitted to Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 2018 to August 2022. All patients underwent MRI plain and enhanced scans before surgery. Using the surgical results as a reference, the diagnostic efficacy of different MRI sequences for anal fistula was analyzed.Results Compared with clinical classification and Parks classification, the kappa values were 0.815 and 0.856, respectively, indicating good consistency with surgical results. Among the 98 internal fistula openings and 126 fistula tracts, the accuracy rates were 93.33% and 94.74%, respectively. Under multimodal sequences, there were significant differences in the diagnosis of internal fistula openings and tracts compared with single sequences (P<0.05).Conclusion MRI under multimodal conditions has better diagnostic efficacy for anal fistula, especially in displaying small internal openings and fistula tracts, and can provide reliable basis for preoperative evaluation. This can effectively help clinicians to solve the lesion problem for anal fistula patients.