Perianal Fistüllerin İncelenmesinde Manyetik Rezonans Görüntülemenin Rolü

Yıl 2018, Cilt: 15 Sayı: 1, 25 - 30, 22.04.2018

Muhammed Arslan , Zehra Adıbelli Fevzi Cengiz Gökhan Söker

Öz

Amaç: Biz çalışmamızda perianal fistül, ikincil
uzantılar ve perianal apselerin manyetik rezonans görüntüleme ile
gösterilmesini ve cerrahi tedaviye katkısını değerlendirdik.

Materyal ve Metod: İzmir Eğitim Araştırma
Hastanesi genel cerrahi kliniğinde fizik muayene ile perianal fistül tanısı
konan 29 hasta çalışmamıza kabul edildi. Manyetik rezonans görüntüleme ile
perianal fistüllerin tipleri belirlendi. Radyolojik görüntüleme sonrası opere
olan 29 hastanın operasyon sonrası tanısı ve uygulanan cerrahi yöntem
değerlendirildi.

Bulgular: Fizik muayene ile 14 hastada (% 48.3)
intersfinkterik,  13 hastada (% 44.8)
transsfinkterik,  2 hastada (% 6.9)
suprasfinkterik fistül saptandı. Manyetik rezonans görüntüleme ile fistül
lokalizasyonu 13 hastada (% 44.8) intersfinkterik, 14 hastada (% 48.3)
transsfinkterik ve 2 olguda (% 6.9) suprasfinkterik fistül şeklinde idi.
Operasyon sonrası tanı referans alındığında fizik muayenenin tanı değeri %64 ve
manyetik rezonans görüntüleme için tanı değeri %82 olarak hesaplandı.

Sonuç: Manyetik rezonans görüntüleme perianal fistül,
sekonder uzantıları ve perianal apse için duyarlı ve özgül bir tanı yöntemidir.
Ayrıca manyetik rezonans inceleme perianal fistül sınıflandırmasında güvenilir
bilgiler verir.

Anahtar Kelimeler

Perianal Fistül, Manyetik Rezonans Görüntüleme, Perianal Apse

The Role of Magnetic Resonance Imaging in Determining of Perianal Fistulas

Öz

Purpose: We evaluated the
determination of perianal fistula, secondary extensions and perianal abscesses
using magnetic resonance imaging and the contribution of this to surgical
treatment.

Materials and methods:  29
patients diagnosed with perianal fistula at physical examination at the Izmir
Education Research Hospital were included in the study. Types of perianal
fistula were identified using magnetic resonance imaging. Diagnosis and the
surgical technique performed in the 29 patients operated on following magnetic
resonance imaging were assessed.

Results: Intersphincteric
fistula was determined in 14 patients (48.3%), transsphincteric fistula in 13
(44.8%) and suprasphincteric fistula in 2 (6.9%). Fistula localization using
magnetic resonance imaging was intersphincteric in 13 patients (44.8%),
transsphincteric in 14 (48.3%) and suprasphincteric in 2 (6.9%).  When postoperative diagnosis was adopted as a
reference, the diagnostic value of physical examination was calculated at 64%
and that of magnetic resonance imaging at 82%.

Conclusion: Magnetic resonance
imaging is a sensitive and specific diagnostic technique for identifying
perianal fistula, secondary extensions and perianal abscess. Magnetic resonance
imaging also provides reliable information concerning perianal fistula
classification. 

Anahtar Kelimeler

Perianal Fistulas, Magnetic Resonance Imaging, Perianal Abscesses

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