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《Radiologic Practice》 2018-01
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Clinical value of MRI in the diagnosis of congenital anorectal malformation

ZHU Cai-di;XIAO Xin-lan;DING Shan;Department of Radiology,Jiangxi Children's Hospital;  
Obective:To evaluate the value of MR examination in the diagnosis of congenital anorectal malformation(ARM).Methods:The clinical and MRI materials of 27 pediatric patients with ARM were retrospectively analyzed,and correlated with surgery findings.Results:Of the 27 patients diagnosed as ARM,the position involved were high-type(10 patients,37%),intermediate-type(5 patients,18.6%),and low-type(12 patients,44.4%).In all 27 cases,multiple plane MRI could clearly show the development of perianal muscles,which could be small and poorly assessed,and even partially overlapped.In the patients of intermediate-and high-type,fairly developed perianal muscles were shown in 3 cases,and poorly developed in 12 cases;in the patients of low-type,well developed in 7 case,fairly developed in 1 case,and poorly developed in 4 cases.The findings of surgery were as follows:in the cases of intermediate-and high-type,fairly developed in 5 cases,and poorly developed in 10 cases;in the cases of low-type,there were well developed in 10 cases,and fairly developed in 5 cases.Of the 27 patients with ARM,there were 19 patients(70%)with associated fistula revealed on surgery,with urethral fistula(6 patients),perineal fistula(8 patients),vescial fistula and vaginal fistula in 2 patients each,and 1 case with fistula to the surface of root of scrotum.Fistula could only be clearly demonstrated on MRI in 10 patients;which could not be clearly shown or even be hardly seen in the remaining 9 cases.Conclusion:MR examination can help to judge the type of ARM accurately,and evaluate the development of perianal muscles,especially for the cases of intermediate-and high-type.Part of the ARM patients had combination with fistula,as well as associated genitourinary system malformation and spinal vertebral anomalies,some of them could also be displayed on MRI.MRI could provide important information for surgery planning.
【Fund】: 江西省科技厅一般项目(20161BBG70146);; 江西省卫生厅项目(20161123)
【CateGory Index】: R445.2;R726.5
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