摘要
目的探讨经肛管腔内超声造影诊断肛瘘的临床价值。方法回顾性分析2016年1月-2017年8月于本院就诊的54例肛瘘患者的临床及影像学资料,以术中结果为金标准,对比经肛管腔内超声造影和肛周超声诊断肛瘘的价值。结果经肛管腔内超声造影和肛周超声对低位单纯性肛瘘、高位单纯性肛瘘、低位复杂性肛瘘、高位复杂性肛瘘的术前诊断符合率分别是100%vs 100%、100%vs 90%、100%vs 77.7%、78.6%vs 38.1%,与肛周超声相比,经肛管腔内超声造影有更高的准确率,特别是对于高位复杂性肛瘘。两者诊断内口、主瘘道和支瘘道的准确率分别是94.4%vs 96.3%、92.6%vs 66.7%、90.7%vs 59.3%,差异有统计学意义(P<0.05)。结论经肛管腔内超声造影检查诊断肛瘘更加可靠,可作为临床检查复杂性肛瘘的首选方法。
Objective To explore the clinical value of hydrogen peroxide-enhanced transanal ultrasound （HPUS） in diagnosis of anal fistulas. Methods Clinical and imaging data of 54 patients with anal fistula who were treated in our hospital from January 2016 to August 2017 were retrospectively analyzed. Accuracies of HPUS and color Doppler ultrasound （CDFI） for diagnosis of anal fistulas were evaluated using surgical finding as gold standard. Results The accuracy of HPUS was similar with CDFI in diagnosis of low simple anal fistulas （100% vs 100%）, but higher for high simple anal fistula （100% vs 77.7%, P=-0.081） and lower complex fistula （100% vs 78,6%, P=0.082） without significant differences. Moreover, HPUS was superior to CDFI in diagnosis of high complex fistulas （90% vs 38.1%, P 〈 0.01）, especially for location of internal opening （94.4% vs 66.7%, P=0.014）, and secondary extension （92.6% vs 59.3%, P 〈 0.01）. There was no significant difference in diagnosis of the primary fistula tract （96.3% vs 90.7%, P=0.083） between the two methods. Conclusion HPUS can be used as an optimal choice for the diagnosis of complex anal fistulas.
作者
姚蒙洁
刘志为
郭柏华
刘庆
胡茂飞
吕发勤
乔璐
卢灿荣
闻巍
吴盛正
YAO Mengjie, LIU Zhiwei, GUO Baihua, LIU Qing, HU Maofei, LYU Faqin, QIAO Lu, LU Canrong, WEN Wei, WU Shengzheng(Department of General Surgery, Hainan Branch of Chinese PLA General Hospital, Sanya 572013, Hainan Province, Chin)
出处
《解放军医学院学报》
CAS
2018年第3期212-214,共3页
Academic Journal of Chinese PLA Medical School
基金
三亚市医疗卫生科技创新项目(2017YW13)~~
关键词
肛瘘
经肛管腔内超声
超声造影
anal fistula
transanal ultrasound
contrast-enhanced ultrasound
