MRIfindingsofperianorectalinfectionindiabeticpatients

Abstract:

Objective：ToinvestigatetheMRIfindingsofperianalinfectionindiabeticpatients.Methods：AretrospectiveanalysiswasperformedontheMRIfilmsof300diabeticpatientswithperianaldiscomfortswhounderwentMRIexaminationoftheanusandrec－tuminourhospitalfromSeptember2009toDecember2017；thefollowingwereanalyzedandrecordedbytworadiologistsexperi－encedintheMRIdiagnosisofpelvicdiseases：perianalinflammation，perianalabscess，glutealfatpadinflammation，glandularanalfistula（fistulatypeandmainfistulalocation，maininternalfistulalocation，branchfistulanumber，externalfistulastatus，distancebe－tweentheexternalapertureandtheverticallineoftheanus），sinus，dynamiccontrast-enhancedsignalchange，non-glandularanalfistula.Results：Abnormalsignalchangesinthepelvicfloorwerefoundin241ofthe300cases，includinganalcanalinflammation，thickeningofmucousmembraneintheanalcanal，vasculardilation，hemorrhoidswithinfection，perianalabscess，perinealcellulitisorabscess，glutealcellulitisorabscess，glandularanalfistula（Parkstype），non-glandularanalfistula，orco-existenceoftheabovemani－festations；amongthese，therewere212casesofperianalvascu－lardilation，hemorrhoids，andanalcanalinflammation，157cas－esofglutealfatpadinflammation，132casesofperianorectalspaceabscess（including8casesofabscessinvolvingsuperiorlythespacebelowandaroundtherectalmucosa，17casesofab－scesslocalizedwithintheposteriordeepspacebetweentheposterioranalsphincters，26casesofabscessspreadingtoperi－analareasalongtheposteriordeepspaceoftheanalcanal，27casesofabscessspreadinganterioinferiorlytotheperineumafterperfo－ratingtheexternalsphincter，22casesofabscessspreadingposterioinferiorlytotheglutealfatpadafterperforatingtheexternalsphincter，23casesofabscessspreadingalongtheinter-sphincterspacetotheglutealcleftduetofailuretoperforatethesphincters，and9casesofabscesswidelyspreadingalongtheabovetwoorthreepaths）；moreover，therewere144casesofanalfistula，ofwhich，98weresimplefistula（including41casesofinter-sphincterfistula，22casesoftrans-sphincterfistula，16casesofextra-sphinc－terfistula，10casesofsuperior-sphincterfistula，and9casesofParkstypeundefined），and46werecomplexfistula（including25casesofinter-sphincterfistulawithtrans-sphincterfistula，11casesofsuperior-sphincterfistulawithinter-sphincterfistula，3casesofsuperior-sphincterfistulawithtrans-sphincterfistula，and7casesoffistulaundefined）.Therewere89mainfistulas（41casesspreadingwithinthesphincters，22casesspreadingtotheischioanalfossaafterperforatingtheanalcanalandexternalsphincter，16casesspreadingsuperiorlywithintheinter-sphincterspaceafterperforatingtheanalcanal，andthenintotheischioanalfossafollow－ingperforatingtheexternalsphincter，and10casesspreadingabovethesphincter），and138branchfistulas（32branchesextendingtothespacearoundorbelowtherectalmucosa，64branchesextendingtotheinter-sphincterspace，and42branchesextendingtotheposteriordeepspaceoftheanalcanal）.Themorphologicalfeatureswereasfollows：markedearlyenhancementforthefistulaandinternalfistulaorificeafterdynamicenhancement，slighthyperintensityofabscessonDWI，markedenhancementforabscesswithperipheralinfections，mostlydelayedenhancementforthefistulawall，anddelayedenhancementforthefibrousinternalfistulaorifice.Conclusion：Perianalinfectionisverycommonindiabeticpatients.MRIprovidesaccuratediagnosisforperianallesionsindiabeticpatients.