The Establishment Of 3D Visualization Model Of Pelvic MRI And The Preliminary Study Of Guiding The Operation Of Anal Fistula In Crohn’s Disease

Purpose:Under the guidance of the concept of multi-disciplinary cooperation,the three-dimensional reconstruction method is used to post process the image of ordinary Pelvic MRI images and establish a three-dimensional visualization model of anal fistula.Through the observation of 3D-MRI images,the relationship between the internal opening,main pipe,branch pipe,purulent cavity and internal and external anal sphincter of anal fistula was clarified,and the accuracy of the operation results after physical examination under anesthesia was verified,so as to seek an ideal imaging evaluation method of anal fistula,so as to improve the accuracy of preoperative evaluation,achieve the accurate guidance of the selection of operation methods,reduce the injury to anal sphincter and reduce the injury to anal sphincter Recurrence rate,improve the quality of life.Methods:According to the clinical symptoms,special examination and auxiliary examination,the patients who meet the inclusion criteria of the subjects were included in the trial.18 patients who met the inclusion criteria were performed Pelvic MRI and 3D reconstruction.All the patients who were included in the standard received timely surgical treatment after Pelvic MRI examination.In this study,combined with anesthesia physical examination,the results of surgery were taken as the final evaluation criteria,and the results of preoperative evaluation were compared and analyzed between the ordinary MRI group and the 3D-MRI group.The sensitivity of parks classification,inner mouth,main tube,branch/pus cavity display of CD anal fistula was compared,and the change rate of operation mode and anal function after operation were compared.Results:The data of all cases in this study showed that there were statistical differences in the detection rates of inner mouth,main pipe and branch/purulent cavity between MRI group and 3D-MRI group(P.After 1-3 months follow-up,100%of the patients had clinical response after operation,and no serious anal incontinence occurred.Conclusion:The MRI images after three-dimensional reconstruction can be more accurate and intuitive for preoperative evaluation.The diagnostic sensitivity of the inner mouth,main pipe,branch/purulent cavity has been significantly improved,and the anatomical classification of the fistula is more accurate,so that the surgeons can clearly and accurately understand the shape of the fistula,the position of the inner mouth,whether there are branches,purulent cavity,etc.,and fully understand the fistula and the inner cavity The anatomical relationship of the external sphincter is helpful for the preoperative planning,intraoperative guidance of the choice of operation,and effectively improves the surgeon’s cognition of the operation and the optimization of surgical decision-making.