期刊文献+

MRI对糖尿病肛管直肠周围感染的诊断价值 预览

Diagnostic value of MRI for diabetic perianorectal infection
在线阅读 下载PDF
收藏 分享 导出
摘要 目的探讨MRI对糖尿病肛周炎症的诊断价值。方法分析2009年9月至2018年4月在重庆市中医院放射科行肛管直肠MRI扫描的350例有糖尿病病史且伴发肛周不适患者的影像学图像,并记录肛周炎症、肛周脓肿、臀部皮下脂肪间隙炎症、腺源性肛瘘(肛瘘分型及主瘘管位置、主内瘘口位置、分支瘘管数目、外瘘口情况、外口距肛垂直线距离)、窦道、动态增强信号改变、非腺源性肛瘘等。结果 350例中271例(77.43%)存在盆底信号异常改变,主要表现为肛管炎症、肛管内黏膜增厚及血管增粗、痔、肛周脓肿、会阴蜂窝组织炎或脓肿、臀部蜂窝组织炎或脓肿、腺源性肛瘘(Parks分型)、非腺源性肛瘘(不典型)或者上述征象共同存在。女性特异性表现为大阴唇脓肿72例(46.45%),男性特异性表现为前列腺、精囊腺及阴茎海绵体脓肿17例(8.72%)。肛周血管增粗、痔疮及肛管炎227例(83.76%),其中伴臀部皮下脂肪间隙炎症162例(59.78%)。肛管直肠周围间隙脓肿141例(52.03%)。形成肛瘘患者154例,其中108例(70.13%)为单纯型肛瘘,46例(29.87%)为复杂性肛瘘。主瘘管共89支,分支瘘管共150支,43例患者存在外瘘口。表现为单一主内瘘口92例,多发内瘘口41例(共89个主内瘘口)。图像形态学表现为动态增强后瘘管及内瘘口呈早期明显强化,DWI对脓肿显示敏感呈稍高信号,脓肿伴周围感染呈明显强化,瘘管壁及纤维型内瘘口呈延迟强化。结论 MRI可对糖尿病患者肛周病变提供精确诊断。 Objective To investigate the diagnostic value of magnetic resonance imaging(MRI) for diabetic perianal lesion. Methods Imaging images of 350 patients undergoing anorectal MRI scan for perianal discomfort with a history of diabetes in the Department of Radiology from September 2009 to April 2018 were analyzed retrospectively by two associate chief physicians, and the items recorded and analyzed included perianal inflammation, perianal abscess, hip subcutaneous fat space inflammation and adeno-anal fistula(anorectal fistula typing, main fistula position, location of the main fistula internal opening, number of branch fistula, external fistula conditions, distance from the external opening to the anal vertical line), sinus tract, dynamic enhanced signal change, and the non-adenoid fistula. Results Abnormal changes in pelvic floor signal were found in 271(77.43%) of the 350 cases, including anal canal inflammation, thickening of mucosa, vascular enlargement, hemorrhoid formation, perianal abscess, perineal cellulitis or abscess, hip cellulitis or abscess, adeno-anal fistula(Parks type), nonadeno-anal fistula(atypical), or coexistence of the above signs. There were 72(46.45%) cases of labial abscess in females, 17(8.72%) cases of prostate, seminal vesicle or penis abscess in males. There were 227(83.76%) cases of perianal vascular thickening, hemorrhoids or anal canal inflammation, including 162(59.78%) cases of subcutaneous fat space inflammation in the buttocks and 141(52.03%) cases of perianal space abscess. There were 154 cases of anal fistula, of whom 108(70.13%) were simple anal fistula and 46(29.87%) complex anal fistula; 89 main fistulas, 150 branch fistulas and 43 patients had external fistula(detailed findings); There were 92 single internal fistulas, 41 multiple internal fistula and 89 main internal fistulas(specific internal fistula). The image morphology showed that early obvious enhancement of the fistula and internal fistula after dynamic enhanceme
作者 王军大 张桢 杨华 方玉 刘映江 吴青青 梅秀婷 李艳艳 WANG Jun-da1, ZHANG Zhen2, YANG Hua1, FANG Yu1, LIU Ying-jiang1, WU Qing-qing1, MEI Xiu-ting1, LI Yan-yan3(1.Department of Radiology, 2.Department of Anoreetal, 3.Department of Pharmacy, Chongcting Traditional Chinese Medicine Hospital, Chongqing 400021, China)
出处 《解放军医学杂志》 CSCD 北大核心 2018年第9期769-775,共7页 Medical Journal of Chinese People's Liberation Army
基金 重庆市卫计委医学科研项目(2017HBRC013)
关键词 糖尿病 肛管直肠病变 肛瘘 磁共振成像 Diabetes anorectal lesions anal fistula magnetic resonance imaging
作者简介 王军大,硕士研究生。主要从事盆底放射诊断方面的研究;[通讯作者]李艳艳,E-mail:403819282@qq.com
  • 相关文献

参考文献4

二级参考文献34

  • 1张霖,刘汉菊,金银华,宋扬,闫敏,许珊,申国强,.复杂性肛瘘患者MRI与超声诊断对比分析[J].中国老年学杂志,2014(2):371-373. 被引量:5
  • 2邱磊,谢沛标,廖健南.复杂肛瘘术前MRI检查的临床价值研究[J].辽宁中医学院学报,2005,7(6):543-544. 被引量:6
  • 3蔡香然,孟悛非,张中伟,刘斯润.肛瘘的高分辨MRI表现[J].中华放射学杂志,2007,41(7):712-715. 被引量:22
  • 4吴阶平 裘法祖.黄家驷外科学[M]5版[M].北京:人民卫生出版社,1992.1385-1386. 被引量:71
  • 5吴在德 吴肇汉.外科学[M].北京:人民卫生出版社,2004.570. 被引量:323
  • 6Kuo CF,Wang WS, Lee CM, et al.FourMefs gangrene. ten-year experience in a medical center in Northern Tai wan[J]. Microbiol Immunol Infect, 2007,40 (6) : 500- 506. 被引量:1
  • 7Chen SY, Fu JP, Wang CH, et al. Fournier gangrene: a review of 41 patients and strategies for reconstruction [J].AnnPlast Surg,2010,64(6) :765- 769. 被引量:1
  • 8Korhonen K, Kuttila K, Niinikoski J.Tissue gas tension in patients with necrotising fasciitis and healthy controls during treatment with hyperbaric oxygen=a clinical study [J].Eur J Surg.2000,166(?) :530-534. 被引量:1
  • 9Frezza EE, Atlas I.Minimal debridement in the treatment of Fournier's gangrene[J].Am Surg, 1999,65 ( 11 ) : 1031 -1034. 被引量:1
  • 10张晓云.肛周脓肿合并糖尿病手术治疗及术后换药的治疗体会[J].中国现代药物应用,2015,12(6):65-66. 被引量:1

共引文献11

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈