本文選題：DWI-MRI + 肛瘺��； 參考：《臨床放射學(xué)雜志》2017年12期

【摘要】：目的探討3.0 T磁共振(MRI)擴(kuò)散加權(quán)成像(DWI)序列及其定量參數(shù)表觀擴(kuò)散系數(shù)(ADC)值在手術(shù)前后準(zhǔn)確評(píng)價(jià)肛瘺活動(dòng)性,以提高手術(shù)成功率同時(shí)降低術(shù)后復(fù)發(fā)率中的應(yīng)用價(jià)值。方法回顧性分析49例經(jīng)手術(shù)證實(shí)的復(fù)雜性肛瘺患者的臨床資料,分析患者常規(guī)MRI及DWI序列圖像特征,通過ADC圖測量病灶A(yù)DC值,根據(jù)臨床評(píng)價(jià)肛周疾病活動(dòng)性指數(shù)(PDAI)將患者分為活動(dòng)期組(19例)與緩解期組(30例),利用兩獨(dú)立樣本t檢驗(yàn)將兩組的ADC均值進(jìn)行比較,并繪制受試者工作特征曲線(ROC);同時(shí)將ADC評(píng)價(jià)活動(dòng)性結(jié)果與PDAI指數(shù)進(jìn)行相關(guān)性分析。結(jié)果測得ADC均值,緩解期組為(1.252±0.170)×10~(-3)mm~2/s,活動(dòng)期組為(0.925±0.148)×10~(-3)mm~2/s,活動(dòng)期瘺管的ADC均值低于緩解期(P0.001)。ROC曲線分析顯示ADC值評(píng)價(jià)肛瘺病變活動(dòng)性的曲線下面積(AUC)為0.94;取曲線中Youden指數(shù)最高時(shí)的截?cái)郃DC值1.101×10~(-3)mm~2/s為鑒別閾值,診斷敏感度為80%,特異度為94.7%(P0.001)。相關(guān)性分析,病灶A(yù)DC值與PDAI值呈負(fù)相關(guān)(r=-0.89,P0.001)。結(jié)論 DWI-MRI序列及其定量參數(shù)ADC值可較準(zhǔn)確地判斷病變活動(dòng)性,應(yīng)作為手術(shù)前后MRI檢查肛瘺的常規(guī)序列加以開展,有助于幫助臨床醫(yī)生術(shù)前制定正確治療方案以提高手術(shù)成功率,更適合于術(shù)后長期隨訪復(fù)查中應(yīng)用。
[Abstract]:Objective to evaluate the value of 3.0T magnetic resonance (MRI) diffusion weighted imaging (DWI) and its quantitative parameter diffusion coefficient (ADC) in the accurate evaluation of anal fistula activity before and after operation in order to improve the success rate of operation and reduce the recurrence rate. Methods the clinical data of 49 patients with complicated anal fistula proved by operation were retrospectively analyzed. The features of conventional MRI and DWI sequences were analyzed. ADC values were measured by ADC map. According to the clinical evaluation of perianal disease activity index (PDAI), patients were divided into active group (19 cases) and remission group (30 cases). The operating characteristic curve (ROC) was drawn and the correlation between ADC evaluation activity and PDAI index was analyzed. Results the ADC mean value was measured. The mean value of ADCs in active fistula was (1.252 鹵0.170) 脳 10 ~ (-3) mm ~ (-3) / s and (0.925 鹵0.148) 脳 10 ~ (-3) mm ~ (-2) / s respectively. The mean value of ADCs in active fistula was lower than that in remission (P0.001) .ROC curve analysis showed that the area under curve (AUC) for evaluating the activity of anal fistula was 0.94.The truncated ADC value (1.101 脳 10 ~ (-3) of the highest Youden index was taken as the differential threshold. The diagnostic sensitivity was 80 and the specificity was 94.7% (P0.001). Correlation analysis showed that there was a negative correlation between ADC value and PDAI value (r-0. 89 鹵P 0. 001). Conclusion DWI-MRI sequence and ADC value of quantitative parameters can accurately judge the activity of the lesion, which should be used as a routine sequence of MRI examination of anal fistula before and after operation, which is helpful to help clinicians to make correct treatment plan before operation to improve the success rate of operation. It is more suitable for long-term follow-up after operation.
【作者單位】： 江蘇省腫瘤醫(yī)院放射科;江蘇省中醫(yī)院放射科;
【分類號(hào)】：R445.2;R657.16

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