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MRI for Evaluation of the Anal Canal Anatomy and Diagnosis of Anal Fistula at 3.0T

Author: LiYing
Tutor: LiChuanFu
School: Shandong University
Course: Medical Imaging and Nuclear Medicine
Keywords: Anal canal Magnetic resonance imaging fistula
CLC: R445.2
Type: Master's thesis
Year: 2008
Downloads: 194
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Abstract


ObjectivesTo evaluate MRI for depicting the anal canal anatomy and diagnosis of anal fistula at 3.0T.Materials and Methods1.33 volunteers without any anorectal diseases and 15 cases with clinically suspected perianal fistula underwent MR imaging at 3.0T MR scanner（GE Signa ExciteⅡ, Milwankee, Wisconsin, U.S.A.） with a 8-channel phased-array surface coil.2.MR pulse sequences included sagittal T2 WI（SAG T2 WI）, coronal T2WI（COR T2WI）, coronal T2WI with fat suppression （COR T2 FS）, axial T1WI（AX T1WI）,axial T2WI（AX T2WI）, axial T2WI with fat suppression（AX T2 FS） and dynamic contrast enhanced magnetic resonance imaging （DCE）.In order to display the anal canal exactly on the axial and coronal planes,we first obtain a sagittal T2-weighted imaging,which reveals the extent and axis of the anal canal.Results1. The anatomic structure of the anal canal including the levator ani, muscle puborectalis,the external annal sphincter muscle was demonstrated distinctly.The upper portion of the anal canal comprised the internal sphincter muscle,the intersphincteric space and the muscle puborectalis.The lower portion of the anal canal comprised the internal sphincter muscle,the intersphincteric space and the external sphincter muscle.The more detailed anatomic structures were depicted at T2 weighted imaging.2. 16 internal opening and 14 tracks were demonstrated in 15 cases.According to John Morris’s study,3 cases were grade1,6 cases were grade2,3 cases were grade3,2 cases were grade4,1 cases were grade5 respectively, 2 cases with perianal abscess were noted. Though the internal opening was shown better at dynamic contrast-enhanced （DCE） imaging than at other sequences, there was no statistical difference between the DCE and Axial T2 FS （P>0.05） . The fitula tracks were demonstrated much better at dynamic contrast-enhanced（DCE） imaging than at other sequences, there was statistical significance only between the DCE and Axial T1 WI （P<0.05）.Conclusion1.3.0T MR Imaging was a simple and feasible way to demonstrate the anorectaland pelvic floor structures.2. Optimized coronal T2 fat suppression images and dynamic contrast-enhancedMR imaging were very helpful for the diagnosis and preoperative planning ofperianal fistula.

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CLC: > Medicine, health > Clinical > Diagnostics > Diagnostic Imaging > Magnetic resonance imaging
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