MRI Findings of Peri-anal Abscess Due to Actinomycosis

放射菌肛門周圍膿瘍在磁振造影的表現

梁庭繼(Ting-Kai Leung) ； 李志明(Chi-Ming Lee) ； 許重輝(Chung-Huei Hsu) ； 陳欣琪(Hsin-Chi Chen)

《中華放射線醫學雜誌》 29卷3期 (2004/06) Pp. 153-156

摘要

我們報告一名五十七歲男性患有放射菌感染之肛門周圍膿瘍，患者起初只有輕微肛門疼痛，由於沒有發現肛部膿水或分泌物之產生，臨床醫師因此無法在早期診斷。核子醫學這時候成功發現病徵處，卻未能排除惡性腫瘤之可能性。磁振造影檢查顯示肛門下腫塊，從其延伸出條狀瘻管，朝向肛門旁皮膚發展，綜合其他發現，磁振造影診斷是良性發炎病變。最後，病理學證實為放射菌感染導致肛門周圍膿瘍。我們認為在手術前的早期肛門周圍膿瘍之診斷，核磁造影具有極高的優越性。

關鍵字

膿瘍 ； 放射菌 ； 肛門 ； 磁振造影

並列摘要

We present a case of a peri-anal abscess infected by actinomycosis in a 57-year-old male who initially suffered from mild anal pain. There was no fever, body weight loss, night sweats or abnormal findings in laboratory tests. There was also no peri-anal discharge. Our diagnosis at that time was inconclusive. A PET scan was then requested. It successfully detected a left peri-anal lesion, but the initial impression based on the dual phases study, was more in favor of malignancy. An MRI study was then performed, which revealed a cystic lesion posterior to the rectum, with a sinus tract leading towards peri-anal skin but without associated soft tissue mass. The patient returned and reported a dark-reddish discharge from his peri-anus about six weeks later. The pathologist finally confirmed it as actinomyocosis.
We concluded that MRI imaging was very advantageous in pre-surgical diagnosis of the peri-anal abscess. The pathologist finally confirmed it as actinomycosis.

並列關鍵字

Abscess ； Actinomycosis ； Anus ； Pelvicorgan ； MR