磁共振DWI联合T<sub>2</sub>WI抑脂序列在复杂性肛瘘诊断中的临床价值<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2026.01.009

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1201 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 【目的】 探讨磁共振弥散加权成像(DWI)联合T₂WI抑脂序列在复杂性肛瘘诊断中的临床价值。【方法】 选取2020年5月至2025年5月淮安市中医院收治的80例疑似复杂性肛瘘患者,所有患者均行磁共振DWI序列及T₂WI抑脂序列检查。以手术病理结果为金标准,观察不同检查序列对肛瘘内口、瘘管的显示情况,分析DWI序列、T₂WI抑脂序列单独及联合诊断的灵敏度、特异度、准确率、阳性预测值及阴性预测值。【结果】 80例疑似复杂性肛瘘患者经手术病理证实存在肛瘘内口85个、瘘管102个。DWI序列、T₂WI抑脂序列联合诊断对肛瘘内口、瘘管的检出率显著高于DWI序列、T₂WI抑脂序列,差异均有统计学意义(P<0.05)。80例疑似复杂性肛瘘患者经手术病理证实阳性62例,阴性18例。T₂WI抑脂序列检查显示阳性58例,阴性22例;DWI序列检查显示阳性57例,阴性23例;联合诊断显示阳性62例,阴性18例。T₂WI抑脂序列、DWI序列联合诊断的准确度、灵敏度、特异度、阳性预测值及阴性预测值均高于经T₂WI抑脂序列、DWI序列单独检查,差异具有统计学意义(P<0.05)。【结论】 磁共振DWI联合T₂WI抑脂序列可有效提高复杂性肛瘘的诊断准确性,为临床治疗方案的制定提供可靠依据,具有较高的临床应用价值。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	孙双
	张莹

关键词 ：直肠瘘, 磁共振成像, 诊断

Abstract：【Objective】 This study aims to evaluate the clinical value of magnetic resonance diffusion weighted imaging(DWI) combined with T₂WI fat suppression sequence in diagnosing complex anal fistula.【Methods】 Eighty patients with suspected complex anal fistula admitted to Huai'an Hospital of Traditional Chinese Medicine from May 2020 to May 2025 were included. All patients underwent magnetic resonance DWI and T₂WI fat suppression sequence examinations. Using surgical pathology results as the gold standard, we observed the visualization of the internal opening and fistula tract of anal fistula using different examination sequences. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of DWI alone, T₂WI fat suppression sequence alone, and their combination in diagnosing complex anal fistula were calculated and analyzed.【Results】 Eighty patients suspected of having complex anal fistulas were confirmed by surgical pathology to have 85 internal fistula openings and 102 fistula tracts. The combined diagnostic method(both T₂WI fat-suppressed sequence and DWI sequence) showed a significantly higher detection rate of internal fistula openings and fistula tracts compared to DWI and T₂WI fat-suppressed sequences, with statistically significant differences(P<0.05). Of the 80 patients suspected of having complex anal fistulas, 62 were confirmed positive and 18 negative by surgical pathology. T₂WI fat-suppressed sequence examination showed 58 positive and 22 negative cases; DWI sequence examination showed 57 positive and 23 negative cases; and the combined diagnostic method showed 62 positive and 18 negative cases. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the combined diagnosis were higher than those of T₂WI fat-suppressed and DWI sequences alone, with statistically significant differences(P<0.05).【Conclusion】 Magnetic resonance DWI combined with T₂WI fat suppression sequence effectively improves the diagnostic accuracy of complex anal fistula. It provides reliable evidence for clinical treatment planning and holds high clinical application value.

Key words： Rectal Fistula Magnetic Resonance Imaging Diagnosis

收稿日期: 2025-07-25

中图分类号:

R657.16

基金资助:*淮安市自然科学研究计划项目(编号:HABZ202113)

引用本文:

孙双, 张莹. 磁共振DWI联合T₂WI抑脂序列在复杂性肛瘘诊断中的临床价值^*[J]. 医学临床研究, 2026, 43(1): 33-35.
SUN Shuang, ZHANG Ying. Clinical Value of Magnetic Resonance DWI Combined with T₂WI Fat Suppression Sequence in Diagnosis of Complex Anal Fistula. JOURNAL OF CLINICAL RESEARCH, 2026, 43(1): 33-35.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.01.009 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I1/33

[1] 周西华.复发性肛瘘的影响因素及手术治疗效果[J].中国现代普通外科进展,2024,27(10):807-810.
[2] 李文强,黄路桥,孙成羽,等. TROPIS治疗复杂性肛瘘的现状及进展[J].现代医学,2024,52(10):1619-1623.
[3] 张敏怡,唐平,任德圣,等. MRI在复杂性肛瘘术前诊断中的应用价值[J].中国CT和MRI杂志,2024,22(10):136-137.
[4] 马茜,殷小平,王佳宁,等. 胰腺局灶性脂肪浸润的CT及MRI影像学表现[J].中国医学计算机成像杂志,2021,27(6):523.
[5] VOGEL J D, JOHNSON E K, MORRIS A M, et al. Clinical practice guideline for the management of anorectal abscess, fistula-in-ano, and rectovaginal fistula[J].Dis Colon Rectum,2016, 59(12): 1117-1133.
[6] 郭高正,王怡明,郑雪平. 高位复杂性肛瘘术后复发危险因素分析[J].上海医学,2022,45(2):99-104.
[7] GARG P, BHATTACHARYA K, YAGNIK V D, et al. Recent advances in the diagnosis and treatment of complex anal fistula[J].Ann Coloproctol,2024, 40(4): 321-335.
[8] 吴许雄,徐丽美,黄娟,等. 3D-HRAM模型诊断及定位复杂性肛瘘术后肛门括约肌损伤的应用研究[J].重庆医科大学学报,2025,50(6):821-827.
[9] 王玉,李传亭,谷超. 磁共振多序列对肛瘘形态学评估效果比较[J].山东医药,2023,63(19):64-66.
[10] 金大永,陈文平,李馨,等. 扩散加权成像联合高分辨率T₂WI在肛瘘内口显示及瘘管分级诊断中的应用[J].结直肠肛门外科,2021,27(1):45-48.
[11] 吴卉卉,冯克,翁苓苓. 磁共振常规序列联合DWI序列用于肛瘘术前诊断准确性分析[J].中国CT和MRI杂志,2024,22(3):123-125.
[12] CHARALAMPOPOULOS A, PAPAKONSTANTINOU D, BAGIAS G, et al. Surgery of simple and complex anal fistulae in adults: a review of the literature for optimal surgical outcomes[J]. Cureus,2023, 15(3):e35888.
[13] 陆文娟,欧阳彬,姚杰,等. MRI-DWI技术诊断复杂性肛瘘的效能及与治疗效果的关联性分析[J].影像科学与光化学,2021,39(2):267-272.
[14] 廖俊杰,王乐富,刘永志,等. 磁共振平扫联合扩散加权成像对宫颈癌术前分期的诊断价值临床研究[J].中国CT和MRI杂志,2021,19(5):86-88.