Analysis of the application value of Morris classification and Freiburger classification in preoperative evaluation of anal fistula based on MRI imaging
[Objectives] To compare the application value of Morris classification and Freiburger classification in preoperative evaluation of anal fistula based on MRI imaging. [Methods] A total of 162 patients diagnosed with anal fistula at Xi’an Daxing Hospital from January 1, 2022, to January 31, 2024, were...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Office of Journal of Colorectal & Anal Surgery
2024-08-01
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| Series: | 结直肠肛门外科 |
| Subjects: | |
| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=306&cateName=2024%E5%B9%B4%20%E7%AC%AC30%E5%8D%B7%20%E7%AC%AC4%E6%9C%9F |
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| Summary: | [Objectives] To compare the application value of Morris classification and Freiburger classification in preoperative evaluation of anal fistula based on MRI imaging. [Methods] A total of 162 patients diagnosed with anal fistula at Xi’an Daxing Hospital from January 1, 2022, to January 31, 2024, were enrolled in this study. All patients underwent anal fistula surgery and underwent MRI plain scan and DWI scan within one week before surgery. MRI images of all patients were evaluated for primary fistulas and abscesses using both Morris classification and Freiburger classification. Surgical records were reviewed, and the corresponding primary fistulas and abscesses were assessed using the aforementioned two classifications. The Kappa consistency test was performed between the MRI-based diagnostic results and surgical diagnostic results, and a forest plot was drawn. [Results] The diagnostic coincidence rates for Morris classification grades 1 to 5 and overall were 97.4%, 93.5%, 100%, 86.9%, 76.2%, and 88.7%, respectively. The diagnostic coincidence rates for Freiburger classification FⅠ to FⅥ and overall were 95.6%, 91.3%, 90.7%, 90.4%, 60.0%, 83.3%, and 87.1%, respectively. The diagnostic coincidence rates for Freiburger classification AⅠ to AⅣ and overall were 100%, 100%, 90.0%, 97.0%, and 97.3%, respectively. The Kappa value for Morris classification based on MRI imaging diagnosis and surgical diagnosis was 0.853, with a 95% CI of 0.794 to 0.912 (P<0.001). The overall Kappa value for Freiburger classification based on MRI imaging diagnosis and surgical diagnosis was 0.918, with a 95% CI of 0.887 to 0.948 (P<0.001). Among them, the Kappa value for fistula (F) diagnosis was 0.838, with a 95% CI of 0.778 to 0.898 (P<0.001), and the Kappa value for abscess (A) diagnosis was 0.982, with a 95% CI of 0.957 to 1.000 (P<0.001). [Conclusion] Compared with Morris classification, Freiburger classification of anal fistula has equivalent diagnostic efficacy for fistulas. Additionally, it demonstrates unique and significant advantages in the diagnosis of complex anal fistulas and abscesses, making it a more effective tool to guide surgical planning. |
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| ISSN: | 1674-0491 |