复杂性肛瘘CT、MRI影像学显示的对比研究

发布时间：2018-04-29 19:38

本文选题：肛瘘 + 瘘管造影　；参考：《泰山医学院》2013年硕士论文

【摘要】：目的探讨同一个复杂性肛瘘病人在CT、MRI显示中的优劣互补性，对其完整显示，为临床大夫手术提供更详细、更准确的资料，避免肛瘘的复发。资料和方法一、一般资料：对30例无肛肠疾病的成年人进行MRI和MSCT扫描。二、方法：MR扫描：患者不需要准备肠道，采取仰卧位，足先进，将耻骨联合定位为磁场中心。扫描序列包括斜轴位T1WI、T2WI、T2WI-FS扫描，斜冠状位T2WI-FS扫描，矢状位T2WI扫描。MSCT扫描：病人呈俯卧位，常规准备肠道，皮肤外口常规消毒后，将一次性输液针头塑料导管一端连接30ml注射器，另一端削尖，然后尽可能的插入瘘管外口，用注射器抽取残液后，注入稀释的35%碘海醇对比剂至有对比剂溢出，擦拭皮肤上的对比剂，进行MSCT扫描及MPR、MIP和VR后处理。结果 MSCT的优点是价格低廉，扫描速度快捷，不需要增强扫描，当造影剂充盈时，，一些不易发现的微小的瘘管分支及隐藏的小脓肿也会被清晰显现，充盈造影剂的管腔呈现高密度，也很容易与低密度的瘘管壁相区分，MPR、MIP及VR技术可以三维立体的观察瘘管形态与走向及炎症的浸润范围，能够为临床医生提供最直观的影像资料。MRI的优点是没有辐射、没有创伤和极强的软组织分辨能力，可以根据肛管、肛管周围肌肉、瘘管及疤痕组织的不同影像学信号得到准确分辨并明确瘘管的走行及炎症的浸润范围。结论 CT与MRI各自优点突出，有机结合CT与MRI这两种技术来作为肛瘘术前诊断的方法，能够取长补短，使外科医生得到尽可能全面的手术信息，制定准确的手术方案，为一次性根治肛瘘提供强有力的保障。
[Abstract]:Purpose To explore the complementarity between the advantages and disadvantages of the same complex anal fistula patients in CT MRI, and to provide more detailed and accurate data for the clinicians in order to avoid the recurrence of anal fistula. Information and methodology 1. General data: MRI and MSCT scans were performed in 30 adults without anorectal diseases. Methods: Mr scan: patients do not need to prepare the intestine, supine position, foot advanced, the pubic symphysis is located as the magnetic field center. The scanning sequence included oblique T1WIN T2WINT2WI-FS scan, oblique coronal T2WI-FS scan, sagittal T2WI scan. MSCT scan: the patient presented prone position, routine preparation for intestinal tract, routine disinfection of the skin external mouth, and then connected one end of the disposable infusion needle plastic catheter to the 30ml syringe. The other end was sharpened, then inserted into the fistula mouth as much as possible. After the residual fluid was extracted with a syringe, the diluted 35% iodohexanol contrast agent was injected into the contrast medium overflow, the contrast agent on the skin was wiped, and the contrast agent was scanned by MSCT and treated with MIP and VR. Result The advantages of MSCT are low cost, fast scanning speed and no need for enhanced scanning. When contrast media is filled, small fistula branches and hidden small abscesses that are not easy to find are clearly displayed, and the lumen filled with contrast media is highly dense. It is also easy to distinguish MPR-MIP and VR from low-density fistula walls. They can be used in three-dimensional observation of fistula morphology and direction and the extent of inflammatory infiltration, and can provide clinicians with the most intuitive imaging data. MRI has the advantage of no radiation. Without trauma and strong soft tissue resolution, we can accurately distinguish the different imaging signals of anal canal, perianal muscles, fistula and scar tissue and determine the path of fistula and the extent of inflammation. Conclusion The advantages of CT and MRI are outstanding. The combination of CT and MRI can be used as a method to diagnose anal fistula before operation, which can make up for each other, so that the surgeon can get the most comprehensive operation information and make up the exact operation plan. To provide a strong guarantee for one-off radical treatment of anal fistula.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R657.16;R816.5;R445.2

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