摘要
目的 分析肛瘘肛周疾病活动性指数(PDAI)与改良Van Assche评分(m-VAI)、瘘管各向异性分数(FA)、表观扩散系数(ADC)的相互关系,探索多模态MRI瘘管活动性定量指标对PDAI的预测价值。方法 回顾性分析双中心103例肛瘘患者临床、MR资料;进行PDAI及m-VAI评分,利用扩散张量成像测定主瘘管的FA和ADC,对PDAI与m-VAI、FA、ADC及PDAI相关的瘘管特征(瘘管数≥3、深部瘘管、瘘管直径>3 mm)进行相关性分析,筛选r值有统计学意义的因素纳入线性回归分析,构建PDAI预测模型。结果 103例肛瘘患者,PDAI为8.00(5.00,11.00),m-VAI为(21.04±4.533),FA为0.182(0.166,0.198),ADC为1.029(0.883,1.111)(×10^(-3)mm^(2)/s),PDAI与m-VAI、FA、ADC及PDAI相关的瘘管特征的r值均有意义(P<0.05),其中与m-VAI、FA、ADC存在中高度相关性(r=0.616、-0.519、-0.673),线性回归模型为Sqrt(PDAI)=1.811+3.769×Sqrt(FA)-2.174×Sqrt(ADC)+0.057×m-VAI+0.118×瘘管数(≥3)+0.302×深部瘘管+0.330×瘘管直径(>3 mm),定量指标中m-VAI、Sqrt(ADC)是Sqrt(PDAI)独立影响因素(b=0.057、-2.174),差异具有统计学意义(P<0.05)。结论 多模态MRI瘘管活动性定量指标与临床评分密切相关,其中m-VAI、瘘管ADC对PDAI预测具有重要价值,为临床肛瘘活动性定量诊断提供影像学依据。
Objective To explore the predictive value of multi-modal MRI quantitative indicators of fistula activity for the clinical score of anal fistula.Methods The clinical and MR data of 103 patients with anal fistulae in two centers were retrospectively analyzed.The perianal disease activity index(PDAI)and modified Van Assche Index(m-VAI)scores were assessed.The fractional anisotropy(FA)and apparent diffusion coefficient(ADC)of the main fistulae were determined by diffusion tensor imaging.Correlation analysis was performed among the PDAI,m-VAI,FA,ADC,and PDAI-related fistula characteristics including 3 or more fistulae,deep fistulae,and fistula diameter>3 mm.Factors with significant r values were selected for linear regression analysis and a PDAI prediction model was constructed.Results Among the 103 patients,the r values of PDAI(8.00)with m-VAI(21.04±4.53),FA(0.182),ADC(1.029×10-3 mm²/s),and PDAI-related fistula characteristics were all significant(P<0.05).There was moderate to high correlation of PDAI with m-VAI(r=0.616),FA(r=-0.519),and ADC(r=-0.673).The linear regression equation is Sqrt(PDAI)=1.811+3.769×Sqrt(FA)-2.174×Sqrt(ADC)+0.057×m-VAI+0.118×(number of fistulae≥3)+0.302x deep fistulae+0.330×(fistula diameter>3 mm).Among the quantitative indicators,m-VAI and Sqrt(ADC)were significant independent influencing factors(b=0.057,-2.174;P<0.05)of Sqrt(PDAI).Conclusion The quantitative indicators of fistula activity on multi-modal MRI are closely related to the clinical scores.The m-VAI score and ADC of the fistula are valuable for predicting PDAI.
作者
林杨皓
李兴华
陈瑞钢
钟文炜
王宇峰
何伟荣
宋亭
LIN Yanghao;LI Xinghua;CHEN Ruigang;ZHONG Wenwei;WANG Yufeng;HE Weirong;SONG Ting(Department of Radiology,Yuedong Hospital,The Third Affiliated Hospital of Sun Yat-Sen University,Guangdong 514000,China)
出处
《影像诊断与介入放射学》
2026年第1期49-56,共8页
Diagnostic Imaging & Interventional Radiology
基金
2024年度广东省医学科研基金立项(A2024794)
2024年度梅州市社会发展科技计划项目(2024C0301167)
2025年梅州市医药卫生科研立项课题(2025-B-93)。
