摘要
目的比较3.0T磁共振(MRI)与直肠腔内超声(TRUS)对肛瘘术前诊断的价值。方法选取2018年2月~2020年9月上饶市人民医院收治的择期实施肛瘘手术的患者100例作为研究对象,所有患者均行3.0T MRI与TRUS检查,以手术结果为金标准,比较MRI与TRUS在肛瘘术前诊断中的诊断符合率、肛瘘分型检出情况以及与手术结果的一致性。结果经手术结果确诊,100例肛瘘患者中,62例括约肌间型瘘,29例经括约肌型瘘,4例括约肌上型瘘,5例括约肌外型瘘;主管104条,支管92条,内口152个;脓肿60个。MRI检查方式下主管、支管、内口检出符合率高于TRUS检查,差异有统计学意义(P<0.05);两种检查方式下脓肿检出符合率比较,差异无统计学意义(P>0.05)。MRI诊断肛瘘分型的准确性为96.00%(96/100),高于TRUS的86.00%(86/100),差异有统计学意义(P<0.05)。经Kappa一致性度量,MRI诊断肛瘘分型与手术结果的一致性为(Kappa=0.925,P=0.000)高于TRUS诊断肛瘘分型与手术结果的一致性(Kappa=0.739,P=0.000)。结论3.0T MRI对肛瘘患者进行手术前检测评估具有很高的准确性,无损伤;TRUS也具较高准确性,且检查快速、操作简便;MRI准确性高于TRUS,但检查的快速简便性弱于TRUS,需根据情况选择或两者结合,术前准确评估,提高手术治愈率,降低复发率。
Objective To compare the value of 3.0T magnetic resonance imaging(MRI)and transrectal ultrasonography(TRUS)in preoperative diagnosis of anal fistula.Methods A total of 100 patients undergoing elective anal fistula surgery admitted to Shangrao People′s Hospital from February 2018 to September 2020 were selected as the research objects.All patients underwent 3.0T MRI and TRUS examination,the surgical results were taken as the gold standard,the consistency of the diagnostic coincidence rate of MRI and TRUS in preoperative diagnosis of anal fistula,detection of anal fistula typing and with the surgical results was compared.Results Diagnosed by the results of surgery,among 100 patients with anal fistula,62 cases were intersphincteric fistulas,29 cases were transsphincteric fistulas,4 cases were suprasphincteric fistulas,and 5 cases were external sphincteric fistulas;there were 104 main ducts,92 branch ducts,and 152 internal opening;60 abscesses.The detection coincidence rate of main ducts,branch ducts and internal opening of MRI examination was higher than that of TRUS examination,the differences were significant statistically(P<0.05).There was no statistically significant difference in the coincidence rate of abscesses between the two examinations(P>0.05).The accuracy of MRI diagnosis of anal fistula classification was 96.00%(96/100),higher than 86.00%(86/100)of TRUS,the difference was significant statistically(P<0.05).According to Kappa consistency measure,the consistency between MRI diagnosis of anal fistula classification and surgical results was(Kappa=0.925,P=0.000),which was higher than that of TRUS diagnosis(Kappa=0.739,P=0.000).Conclusion 3.0T MRI has high accuracy and no damage in preoperative detection and evaluation of patients with anal fistula.TRUS also has high accuracy,fast inspection and easy operation.The accuracy of MRI is higher than that of TRUS,but the rapidity and simplicity of MRI is weaker than that of the TRUS,it is necessary to select or combine them according to the situation,which can acc
作者
郑驰
钱坤
陈裔军
谢嘉俊
魏颖
吴国辉
ZHENG Chi;QIAN Kun;CHEN Yi-jun;XIE Jia-jun;WEI Ying;WU Guo-hui(Department of Imaging,Shangrao People′s Hospital,Jiangxi Province,Shangrao334000,China;Department of General Surgery,Shangrao People′s Hospital,Jiangxi Province,Shangrao334000,China;Department of Pathology,Shangrao People′s Hospital,Jiangxi Province,Shangrao334000,China)
出处
《中国当代医药》
CAS
2021年第11期165-168,共4页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(20204798)。
关键词
肛瘘
3.0T磁共振
直肠腔内超声
肛瘘分型
Anal fistula
3.0T magnetic resonance imaging
Transrectal ultrasonography
Anal fistula classi-fication
