Background:Pediatric perianal fistula is a common disorder.It is more difficult to detect the fistula tract and internal opening(IO)in children than in adults.This study aimed to evaluate the clinical diagnostic value...Background:Pediatric perianal fistula is a common disorder.It is more difficult to detect the fistula tract and internal opening(IO)in children than in adults.This study aimed to evaluate the clinical diagnostic value of transcutaneous perianal ultrasound for children with perianal fistula.Methods:A retrospective review was conducted by analysing the preoperative transcutaneous perianal ultrasound and intraoperative exploration results of 203 consecutive patients who were<3 years old and diagnosed with perianal fistula.Analyses were conducted to evaluate the accuracy and consistency of utilizing the transcutaneous perianal ultrasound in the diagnosis of the complexity and location of the IO of perianal fistulas.Results:Compared with intraoperative exploration,the preoperative transcutaneous perianal ultrasonography has almost perfect agreement(Kappa=0.881,P<0.001)in the diagnosis of fistula tract complexity and IO with a sensitivity of 92%and a specificity of 97%.In addition,both intraoperative exploration and transcutaneous perianal ultrasound diagnosis showed high consistency in the identification of the IO of perianal fistulas(QuadrantⅠKappa=0.831,QuadrantⅡKappa=0.773,QuadrantⅢKappa=0.735,QuadrantⅣKappa=0.802,all P<0.01).The IOs were mainly distributed in QuadrantsⅣandⅡin both simple and complex fistulas.Conclusions:Transcutaneous perianal ultrasound,as a non-invasive and simple imaging technique,showed high accuracy in the diagnosis and identification of the fistula classification and IO location.It could be considered a first-line diagnostic instrument for evaluating perianal fistulas among children.展开更多
基金funded by the Shanghai Hospital Development Center[grant number SHDC22021316A]Shanghai Health Commission[grant numbers ZY(2021-2023)0209-06,PD2020D2].
文摘Background:Pediatric perianal fistula is a common disorder.It is more difficult to detect the fistula tract and internal opening(IO)in children than in adults.This study aimed to evaluate the clinical diagnostic value of transcutaneous perianal ultrasound for children with perianal fistula.Methods:A retrospective review was conducted by analysing the preoperative transcutaneous perianal ultrasound and intraoperative exploration results of 203 consecutive patients who were<3 years old and diagnosed with perianal fistula.Analyses were conducted to evaluate the accuracy and consistency of utilizing the transcutaneous perianal ultrasound in the diagnosis of the complexity and location of the IO of perianal fistulas.Results:Compared with intraoperative exploration,the preoperative transcutaneous perianal ultrasonography has almost perfect agreement(Kappa=0.881,P<0.001)in the diagnosis of fistula tract complexity and IO with a sensitivity of 92%and a specificity of 97%.In addition,both intraoperative exploration and transcutaneous perianal ultrasound diagnosis showed high consistency in the identification of the IO of perianal fistulas(QuadrantⅠKappa=0.831,QuadrantⅡKappa=0.773,QuadrantⅢKappa=0.735,QuadrantⅣKappa=0.802,all P<0.01).The IOs were mainly distributed in QuadrantsⅣandⅡin both simple and complex fistulas.Conclusions:Transcutaneous perianal ultrasound,as a non-invasive and simple imaging technique,showed high accuracy in the diagnosis and identification of the fistula classification and IO location.It could be considered a first-line diagnostic instrument for evaluating perianal fistulas among children.
