扩散张量成像定量联合改良Van Assche评分对肛瘘活动性的诊断价值.

bjective To explore the value of diffusion tensor imaging(DTI)quantification combined with modified Van Assche index in the diagnosis of anal fistula activity. Methods The clinical and MR data of 90 patients with anal fistulae in our hospital were retrospectively analyzed,and the modified Van Assche indices were calculated. The fractional anisotropy(FA)and apparent diffusion coefficient(ADC)values of the main fistula were measured on DTI,and the patients were divided into positive inflammation activity(PIA)group and negative inflammation activity(NIA)group. The differences in the modified Van Assche indices,fistula FA and ADC values between the two groups were compared. The diagnostic efficacy of Van Assche index,FA value,ADC value,and combined assessment of anal fistula activity was analyzed using receiver operating characteristic(ROC)curves and the areas under the ROC curves(AUCs)were compared using the DeLong test. Results The fistula FA value(0. 178±0. 018)and ADC value[(0. 948±0. 138)×10-3 mm²/s]in PIA group were lower than those in NIA group[0. 201±0. 326,(1. 106±0. 086)×10-3 mm²/s]. The modified Van Assche index in PIA group(22. 83±3. 428)was higher than that in NIA group(17. 95±3. 374). DTI,modified Van Assche index,and combined assessment had significantly(P＜0. 05)higher diagnostic efficacy for anal fistula activity(AUC=0. 826,0. 798,0. 851). DeLong test showed that the AUC of the combined assessment was significantly higher than that of the modified Van Assche index(P＜0. 05)whereas there was no significant difference between the AUCs of the combined assessment and DTI nor between AUCs of DTI and the modified Van Assche index(P＞0. 05). Conclusion DTI and modified Van Assche index can effectively diagnose anal fistula activity with best diagnostic efficiency using the combined assessment. [ABSTRACT FROM AUTHOR]