deSouza N M, Gilderdale D J, Coutts G A, Puni R, Steiner R E
Robert Steiner Magnetic Resonance Unit, Royal Post-graduate Medical School, Hammersmith Hospital, London, England.
J Comput Assist Tomogr. 1998 May-Jun;22(3):357-63. doi: 10.1097/00004728-199805000-00004.
The objective of our study was to compare MRI of fistulas-in-ano using an endoanal coil with that using a pelvic phased array coil and to assess the value of a combined approach by correlating the findings with those at surgery.
Twenty consecutive patients with clinical suspicion of perianal sepsis were studied using an endoanal coil immediately followed by a phased array coil. T1 weighted and STIR images in transverse and coronal planes were made with each coil and analysed by noting the presence and site of a collection and primary track, the position of any internal opening, and subcutaneous or supralevator extension. Operative findings were similarly recorded.
Of 20 patients with suspected fistulas, 8 had simple fistulas, 8 had complex fistulas, and 4 had no current evidence of infection. The concordance between MR and surgery for identifying the presence and site of the collection, the primary track, and the internal opening in both simple and complex cases was superior using the endoanal coil as compared with the phased array. Both coils together reflected the findings of the endoanal coil used alone. However, for supralevator/subcutaneous extension, concordance was superior using the phased array compared with the endoanal coil, and a combined approach reflected the values of the phased array coil used alone.
Endoanal MRI is highly sensitive in the delineation of fistulas-in-ano. In combination with phased array techniques, it provides valuable preoperative assessment in both simple and complex cases.
我们研究的目的是比较使用肛管内线圈和盆腔相控阵线圈进行肛管瘘管的磁共振成像（MRI），并通过将结果与手术结果相关联来评估联合方法的价值。
对20例临床怀疑肛周脓肿的连续患者进行研究，先使用肛管内线圈，随后立即使用相控阵线圈。用每个线圈获取横断位和冠状位的T1加权像和短TI反转恢复（STIR）像，并通过记录有无积液及原发瘘管、任何内口的位置以及皮下或肛提肌上扩展情况进行分析。手术结果也进行类似记录。
在20例疑似瘘管患者中，8例为单纯性瘘管，8例为复杂性瘘管，4例目前无感染证据。在识别单纯性和复杂性病例中的积液、原发瘘管及内口的存在和位置方面，与相控阵线圈相比，使用肛管内线圈时磁共振成像（MR）与手术结果的一致性更好。两个线圈联合使用反映了单独使用肛管内线圈的结果。然而，对于肛提肌上/皮下扩展情况，与肛管内线圈相比，使用相控阵线圈时一致性更好，联合方法反映了单独使用相控阵线圈的价值。
肛管内MRI在肛管瘘管的描绘方面高度敏感。与相控阵技术相结合，它在单纯性和复杂性病例中均提供了有价值的术前评估。
