Share：
Share this content in WeChat
X
[Chinese][PDF]79988
• Clinical Article •
The value of 3.0 T high-spatial-resolution MRI in the fistula classification and internal opening location
WEI Xiao-mei  DENG De-mao  LIANG Ling-yan  CHEN Wen-fu  SUN Pei-yi 

DOI:10.12015/issn.1674-8034.2017.05.007.


[Abstract] Objective: To evaluate the value of 3.0 T high-spatial-resolution MR imaging in the fistula classification and internal opening location.Materials and Methods: One hundred and fifty-six patients with anal fistulas underwent 3.0 T high-spatial-resolution MR imaging, and two experienced radiologists analyzed the images separatedly to identify the orientation of the fistula track, the internal opening, whether with ramifications and abscess, and the relationship between the primary track and the anal sphincter, compared with the surgical exploration. All cases were classified according to Parks classification, and the internal openings were expressed by lithotomy position of clock location method. MR imaging was correctly revealed if the internal opening was observed in the same quadrant as the surgical exploration.Results: (1) The coincidence rate was 100% of the classification according to the primary track on MR imaging, compared with surgical exploration in 156 cases: 119 samples and 37 complex anal fistula. The accuracy rates of classification by MR imaging compared with surgical exploration were: inter-sphincteric 97.70% (87/85), trans-sphincteric 96.30% (52/54), supra-sphincteric 90.90% (10/11), extra-sphincteric 85.71% (7/6), respectively. (2) The accuracy rate of internal opening was 92.20% (189/205). (3) 196/198 primary tracks and 20/24 ramifications were identified, the accuracy rate was more than 80%. (4) Seventy-four perianal abscess were confirmed by MRI as well as surgical exploration, the accuracy was equal to 100%.Conclusions: 3.0 T high-spatial-resolution MR imaging and dynamic contrast enhancement scanning has an important clincal value in evaluating the fistula classification and internal opening location.
[Keywords] Proctorectal diseases；Fistula；Magnetic resonance imaging

WEI Xiao-mei Department of Radiology, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, China

DENG De-mao* Department of Radiology, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, China

LIANG Ling-yan Department of Radiology, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, China

CHEN Wen-fu Department of Radiology, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, China

SUN Pei-yi Department of Radiology, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, China

*Correspondence to: Deng DM, E-mail: demaodeng@163.com

Conflicts of interest   None.

Received  2016-10-17
Accepted  2017-03-28
DOI: 10.12015/issn.1674-8034.2017.05.007
DOI:10.12015/issn.1674-8034.2017.05.007.

[1]
周智洋, 刘得超. 肛管和肛周疾病的MRI诊断. 磁共振成像杂志, 2015, 41(11): 868-875.
[2]
叶苏婷, 缪锦芬, 赵志新, 等. 磁共振成像检查在肛瘘手术中的应用价值. 医学影像学杂志, 2013, 2(23): 271-274.
[3]
Tolan DJ. Magnetic resonance imaging for perianal fistula. Semin Ultrasound CT MR, 2016, 37(4): 313-322.
[4]
Hutan M, Hutan MJr, Satko M, et al. Significance of MRI in the treatment of perianal fistula. Bratisl Lek Listy, 2009, 110(3): 162-165.
[5]
Morris J, spencer JA, ambrose NS. MR imaging classification of perianal fistulas and its implications for patient management. Radiographics, 2000, 20(3): 623-625.
[6]
贝绍生, 丁克, 王建新, 等. 三维肛肠超声扫描结合瘘管造影定位诊断肛屡临床研究. 中国实用外科杂志, 2009, 29(9): 773-745.
[7]
张晓蓉, 陈真, 彭勃. 高频线阵与经直肠超声在肛瘘及脓肿诊断中的应用. 中国医学影像技术, 2008, 21(7): 1103-1107.
[8]
Garcés-Albir M, García-Botello SA, Espi A, et al. Three-dimensional endoanal ultrasound for diagnosis of perianal fistulas: reliable and objective technique. World J Gastrointest Surg, 2016, 8(7): 513-520.
[9]
陈富军, 谢亚锋, 李刚, 等. 肛瘘的影像学诊断现状. 结直肠肛门外科, 2012, 18(3): 210-212.
[10]
Sharma G, Khandige G, Mohan M. Magnetic resonance imaging in perianal fistulas-A pictorial atlas. Indian J Gastroenterol, 2016, 35(5): 337-342.
[11]
周静, 储成凤, 黄海青. 高分辨率MRI在复杂性肛瘘诊断中的价值研究. 医学影像学杂志, 2010, 20(2): 208-210.
[12]
胡道予, 王承缘. MR不同序列成像诊断肛瘘的研究. 中华放射学杂志, 2004, 38(1): 66-69.
[13]
Schaefer O, Lohramann C, Langer M. Assessment of anal fistulas with high-redolution subtraction MR-fistulography: comparison with surgical findings. J Magn Reson Imag, 2004, 19(1): 91-98.
[14]
朱琼, 杨烁慧, 詹松华, 等. 直肠内水囊填塞MRI对肛瘘术前诊断的价值研究. 临床放射学杂志, 2010, 29(1): 114-117.
[15]
陆方, 杨烁慧, 朱琼, 等. 肛瘘磁共振成像:探讨直肠球囊双腔导管在肛瘘诊断中的价值. 临床放射学杂志, 2013, 32(4): 582-585.
[16]
张永刚, 李国栋, 杨柏林. 等.磁共振成像在复杂性肛瘘诊断中的价值及临床应用. 中国普外基础与临床杂志, 2010, 17(2): 125-128.

PREV Rectal cancer on MRI diffusion-kurtosis imaging and correlation between DKI parameters and D2-40, CD31, S-100 and Ki-67 in rectal tumors
NEXT Value of DWI in differential diagnosis of uterine empyema and uterine cavity fluid
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn