Department of Radiology, Central Radiodiagnostic Unit, Hospital del Henares, 28822 Coslada, Spain.
Radiographics. 2012 Jan-Feb;32(1):175-94. doi: 10.1148/rg.321115040.
Perianal fistulization is an inflammatory condition that affects the region around the anal canal, causing significant morbidity and often requiring repeated surgical treatments due to its high tendency to recur. To adopt the best surgical strategy and avoid recurrences, it is necessary to obtain precise radiologic information about the location of the fistulous track and the affected pelvic structures. Until recently, imaging techniques played a limited role in evaluation of perianal fistulas. However, magnetic resonance (MR) imaging now provides more precise information on the anatomy of the anal canal, the anal sphincter complex, and the relationships of the fistula to the pelvic floor structures and the plane of the levator ani muscle. MR imaging allows precise definition of the fistulous track and identification of secondary fistulas or abscesses. It provides accurate information for appropriate surgical treatment, decreasing the incidence of recurrence and allowing side effects such as fecal incontinence to be avoided. Radiologists should be familiar with the anatomic and pathologic findings of perianal fistulas and classify them using the St James's University Hospital MR imaging-based grading system.
肛周瘘管是一种炎症性疾病，影响肛门周围区域，由于其高复发倾向，导致发病率显著，并经常需要反复手术治疗。为了采用最佳的手术策略并避免复发，有必要获得关于瘘管位置和受累骨盆结构的精确放射学信息。直到最近，影像学技术在评估肛周瘘管方面的作用有限。然而，磁共振成像（MR 成像）现在提供了关于肛门直肠解剖、肛门括约肌复合体以及瘘管与骨盆底结构和肛提肌平面关系的更精确信息。MR 成像可以精确定义瘘管并识别继发的瘘管或脓肿。它为适当的手术治疗提供了准确的信息，降低了复发的发生率，并避免了诸如粪便失禁等副作用。放射科医生应该熟悉肛周瘘管的解剖和病理表现，并使用基于圣詹姆斯大学医院磁共振成像的分级系统对其进行分类。
