| BackgroundAnal structure of the complex anatomical relation, prone to anal fistula, abscess, and a variety of diseases such as cancer, generally could not be self-healing, after surgical treatment, many patients often relapse, to a certain extent, increase the patient’s mental burden and economic burden. MRI scans and diffusion tensor imaging(DTI) technique, could clearly show the relationship between the location of the anal canal and the surrounding muscle of anal area, and the position of the abscess and fistula and classification, etc, of fistula and the inlet of the intuitive and accurate spatial orientation.ObjectiveUsing MRI scans and diffusion tensor imaging(DTI) technique, observation anus of anal canal and the surrounding muscle length, thickness, angle, fractional anisotropy(FA), and the position of the abscess and fistula and classification, etc, to explore the MRI in the clinical application value of anus week lesions, improve the structure of anal area lesion detection rate and diagnosis accuracy, provide reliable morphological basis for clinical surgery plan formulation.MethodsCollected during June 2011 to July 2015, to come to Anyang city people’s hospital, 100 cases of anal area normal images and 40 cases of anal area lesions, of which use American GE company of 1.5T superconducting MRI machine, respectively on T1WI, T2WI, short time inversion recovery(STIR) sequence and diffusion tensor imaging scanning, the original image data input GE workstation for reconstruction and analysis. Observation anus of anal canal and the surrounding muscle length, thickness, angle, fractional anisotropy, and the position of the abscess and fistula and classification, etc, comparing the resting state and holds state of anal canal length, anorectal angle, distance, sacral on anal former distance and conventional magnetic resonance imaging(MRI) and diffusion tensor imaging of the anal sphincter, anal levator muscle fibers differences in disorder, and MRI imaging and surgical observations fistula and inside the mouth and anus week abscess coincidence rate, sensitivity, and various types of anal fistula rate, sensitivity and coincidence rate. Using SPSS 16.0 software for statistical processing, measurement data using mean ± standard deviation (x±s) said.Results1. On MRI scan sequence images, anal anal area and the surrounding muscles were shown, including T1WI, T2WI, short time inversion recoverysequence cross sectional level and short time inversion recoverysequence tubing coronary level could be the best show. Men and women of the groove width between the thickness of the anus sphincter, anal sphincter, anal sphincter length and thickness, the front outside the anus sphincter length and thickness, outside the anus sphincter at the back of the length and thickness were no significant difference(P>0.05). Outside the anus sphincter of the length and thickness of the front and the rear there was significant difference(P<0.05), it were (12.57±2.68) mm and (18.02±18.02) mm, (5.01±1.11) mm and (17.59±2.63) mm of the men, it were (12.11±2.80) mm and (18.43±18.43) mm, (4.61±0.92) mm and (18.21±4.67) mm of the women respectively. Male and female pubic rectum, anus levator muscle length and thickness and joint longitudinal muscle thickness were no significant difference(P>0.05). Male and female ball sponge muscle thickness, the thickness of the perineal body exist significant difference(P<0.05), it were (4.30±0.91) mm and (2.48±2.48) mm, (3.53±0.35) mm and (6.76±0.69) mm respectively.2. Men and women of anal sphincter length and width, relative value of pubic rectum muscle length and width were no significant difference(P>0.05). Resting state and holds state of anal canal length, anorectal angle, distance, sacral on anal distance before there were significant differences(P<0.05), it were (37.44±4.01) mm and (25.70±25.70) mm, (89.40±5.15)° and (103.30±7.54)°, (1.73±0.26) mm and (21.30±21.30) mm, (11.15±0.62) mm and (9.31±0.53) mm respectively. Resting state and holds state of anal sphincter, fractional anisotropy, there were significant differences(P<0.05), it were (0.70±0.03) s/mm2and (0.67±0.03) s/mm2, (0.41±0.02) s/mm2and (0.31±0.04) s/mm2 respectively. Conventional magnetic resonance imaging(MRI) and diffusion tensor imaging of the anal sphincter, anal levator muscle fibers disorder there were significant differences(P<0.05),it were 0%(0/100) and 15%(15/100),24%(24/100) and 35%(35/100).3. Anal fistula in a slightly low signal on T1WI sequence images, in T2WI and STIRsequence image had high signal on the shadow. According to the Parks in the anal fistula classification of anal sphincter, anal sphincter, anal sphincter, anal sphincter appearance of proportional were 26.1%(6/23),56.5%(13/23),8.7%(2/23),8.7%(2/23). Compared with the surgical observations, MRI imaging diagnosis of anal fistula fistula, the sensitivity of fistula in the mouth and anus week abscess were 92.6%(25/27), 91.7%(22/24),100%(10/10), coincidence rate were 92.6%(25/27),84.6%(22/26), 90.9%(10/11). MRI imaging in the diagnosis of anal fistula Parks classification of anal sphincter, anal sphincter, anal sphincter, anal sphincter appearance on the sensitivity were 100%(6/6),84.6%(11/13),100%(2/2),100%(2/2), coincidence rate were 100%(6/6), 78.6%(11/14),100%(2/2),100%(2/2).Conclusion1. MRI scanning and diffusion tensor imaging could well show anal area structure of anal canal and the surrounding muscles, to improve the structure of anal area lesion detection rate and diagnosis accuracy of the data provides intuitive anatomy.2. MRI images could clearly show the location and size of abscess and fistula, accurately show the inside and outside the open of the fistula and its relation with the location of the anal sphincter, plan and evaluation of curative effect after operation for the development of clinical surgery, provide reliable morphological basis. |
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