Akyel Nazlı Gülsüm, Akın Kayıhan, Kösehan Dilek, Köktener Aslı
Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
Lokman Hekim Akay Hospital, Ankara, Turkey.
Pol J Radiol. 2019 Nov 4;84:e430-e435. doi: 10.5114/pjr.2019.89906. eCollection 2019.
Perianal fistula is an important health problem with devastating morbidity. For diagnosis and prevention of recurrence, perianal fistula imaging (PFI) is crucial. The aim of this study was to investigate if a Flex-M superficial coil images would provide more information than images obtained with a phased-array body coil in PFI.
Thirty-one fistulas of 29 patients were prospectively evaluated with magnetic resonance imaging. A phased-array body coil was used in all patients as in routine practice, and sequences with Flex-M coil were also obtained. Afterwards, images were evaluated by two experienced radiologists who were blinded to the patients, coil and also to each other. The site of internal and external openings, and presence or absence of abscess and secondary tracts were recorded.
The conspicuity of images was better with the Flex-M coil. Both radiologists saw more internal openings with the Flex-M coil. Cohen's κ value was 0.100 ( = 0.201) for Reader 1 and 0.110 ( = 0.361) for Reader 2 between these two coils. Additionally, numerically more internal/external openings and secondary tracts were seen by both readers. Interobserver variability was not statistically significant, and Cohen's κ values signifyied good concordance between readers.
In our study we showed that multichannel superficial phased-array coils improved imaging quality in PFI. We think that Flex-M coil can easily be used in routine clinical practice to gather better images of perianal fistulas.
肛周瘘是一个重要的健康问题，会导致严重的发病率。对于肛周瘘的诊断和复发预防，肛周瘘成像（PFI）至关重要。本研究的目的是调查在PFI中，Flex-M表面线圈成像是否比相控阵体线圈成像能提供更多信息。
对29例患者的31个瘘管进行了磁共振成像的前瞻性评估。所有患者均按常规使用相控阵体线圈，并获取了Flex-M线圈序列的图像。之后，由两名经验丰富的放射科医生对图像进行评估，他们对患者、线圈以及彼此的评估结果均不知情。记录内口和外口的位置，以及是否存在脓肿和继发瘘管。
Flex-M线圈成像的清晰度更好。两位放射科医生通过Flex-M线圈都发现了更多的内口。两位读者在这两种线圈之间的Cohen's κ值，读者1为0.100（=0.201），读者2为0.110（=0.361）。此外，两位读者在数值上都发现了更多的内/外口和继发瘘管。观察者间的变异性无统计学意义，Cohen's κ值表明读者之间具有良好的一致性。
在我们的研究中，我们表明多通道表面相控阵线圈提高了PFI的成像质量。我们认为Flex-M线圈可以很容易地用于常规临床实践，以获取更好的肛周瘘图像。
