1Department of Radiology, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom 2Department of General Surgery, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom 3Department of Gastroenterology, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom 4Department of Dermatology, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom 5Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
Dis Colon Rectum. 2014 Jun;57(6):762-71. doi: 10.1097/DCR.0000000000000131.
Hidradenitis suppurativa is a rare chronic inflammatory disorder of apocrine gland-bearing skin, which commonly affects the anogenital region. There has been very little literature to date on the MRI appearances of anogenital hidradenitis suppurativa.
The aim of this study was to assess the MRI features of anogenital hidradenitis suppurativa in the largest cohort of patients to be published to date.
After an institutional review board waiver, patients with hidradenitis suppurativa who were undergoing MRI for anogenital disease between 2005 and 2012 were identified from our institutional database. The MRI appearances were recorded by 2 radiologists in consensus, blinded to clinical details. Location of disease, number of tracts, presence of anal fistula, and supralevator involvement were recorded. Patient demographics were also noted.
This study was conducted at the Department of Radiology, Guy's and St Thomas' National Health Service Foundation Trust.
Patients included were those undergoing MRI for anogenital disease in hidradenitis suppurativa between 2005 and 2012.
The distribution of sinus tracts in anogenital hidradenitis suppurativa on MRI was measured.
Thirty-one MRIs were performed in 18 patients (15 men; mean age, 46 years). On the baseline MRI, multiple tracts were seen in the natal cleft (16/18; 83%), the perianal (12/18; 61%), the perineal (13/18; 56%), and the gluteal (8/18; 44%) regions. A communication with the anal canal was present in only 4 patients. Three patients had supralevator extension. Seven patients had follow-up MRIs with variable response to interval treatment: 3 of 7 showed responding disease, 3 of 7 showed stable disease, and 1 of 7 showed progressive disease.
This study was limited by its relatively small cohort of patients.
In hidradenitis suppurativa, anogenital disease is usually subcutaneous but extensive, with only a minority of patients demonstrating deeper involvement. MRI may help define the extent of anogenital disease and assess response to treatment.
化脓性汗腺炎是一种罕见的、发生在顶泌汗腺分布区域的慢性炎症性疾病，通常影响会阴部。迄今为止，关于化脓性汗腺炎的 MRI 表现的文献很少。
本研究旨在评估迄今为止发表的最大化脓性汗腺炎患者队列的 MRI 特征。
在机构审查委员会豁免后，我们从机构数据库中确定了 2005 年至 2012 年间因会阴部疾病而接受 MRI 检查的化脓性汗腺炎患者。两名放射科医生在盲法的情况下，根据临床细节，对 MRI 表现进行了共识记录。记录了病变的位置、窦道的数量、肛痿的存在和上骼窝受累情况。还记录了患者的人口统计学资料。
本研究在英国盖伊和圣托马斯国民保健服务基金会信托基金的放射科进行。
纳入的患者为 2005 年至 2012 年间因会阴部疾病而行 MRI 检查的化脓性汗腺炎患者。
测量化脓性汗腺炎的 MRI 上窦道的分布。
18 例患者进行了 31 次 MRI（15 例男性；平均年龄 46 岁）。在基线 MRI 上，18 例患者中有 16 例（83%）在会阴裂、12 例（61%）在肛周、13 例（56%）在会阴和 8 例（44%）在臀区可见多个窦道。仅有 4 例患者的窦道与肛门相通。3 例患者有骼窝以上的扩展。7 例患者进行了随访 MRI，根据间隔治疗的反应分为 3 种情况：7 例中有 3 例病变缓解，7 例中有 3 例病变稳定，7 例中有 1 例病变进展。
本研究的局限性在于患者队列相对较小。
在化脓性汗腺炎中，会阴部疾病通常为皮下病变，但范围广泛，只有少数患者有深部受累。MRI 可能有助于确定会阴部疾病的范围，并评估治疗效果。
