慢性放射性直肠炎经直肠超声表现  

Endorectal ultrasonographic features of chronic radiation proctitis

作　　者：曹飞[1] 马腾辉[2] 王磊[2] 王怀明[2] 文艳玲[1] 刘小银[1] 黄斌杰[2] 钟清华[2] 刘广健[1] 

机构地区：[1]中山大学附属第六医院超声科,广东广州510655 [2]中山大学附属第六医院结直肠外科,广东广州510655

出　　处：《中国医学影像技术》2016年第10期1536-1539,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的 观察慢性放射性直肠炎的经直肠超声表现。方法 对52例晚期宫颈癌放疗后发生慢性放射性直肠炎患者行经直肠超声检查,其中7例已行横结肠造瘘（造瘘组）,45例未行横结肠造瘘术（非造瘘组）,采用二维灰阶超声观察并记录可探及范围内直肠肠壁厚度和层次、溃疡及直肠阴道瘘等情况;能量多普勒观察肠壁血流,并根据Limberg标准进行分级。分析肠壁厚度与血供分级的相关性;比较造瘘组与非造瘘组患者病变肠壁厚度、血流情况。结果 52例患者病变肠壁平均厚度（7.88±2.05）mm,肠壁血供Ⅲ~Ⅳ级35例（35/52,67.31%）;肠壁厚度与血供分级存在相关性（rs=0.48,P〈0.01）;造瘘组与非造瘘组患者肠壁厚度、血供分级的差异均有统计学意义（P均〈0.05）。结论 慢性放射性直肠炎的经直肠超声特征性表现为病变肠管壁弥漫性增厚、血流信号增多。Objective To observe the imaging features of chronic radiation proctitis （CRP） by endorectal ultrasound （ERUS）.Methods ERUS was performed on 52 CRP patients who were treated with radiation therapy for advanced cervical cancer. There were 7 patients with transverse colostomy （colostomy group） and the remaining 45 patients without colostomy （non-colostomy group）. The rectal wall thickness and layers, ulcers, and rectovaginal fistula in the range of detection were observed and recorded by B-mode ultrasound. Power Doppler was used to evaluate the blood flow of the rectal wall which was classified according to Limberg criteria. The relationship between rectal wall thickness and blood flow grade was analyzed, and the thickness and blood flow of rectal wall between colostomy group and non-colostomy group was compared.Results For all 52 patients, the average thickness of rectal wall was （7.88±2.05） mm, and the blood flow of rectal wall was classified level Ⅲ-Ⅳ in 35 patients （35/52, 67.31%）. There was a correlation between rectal wall thickness and blood flow grade （rs=0.48, P〈0.01）. The differences of the thickness of the rectal wall and blood flow grade between the two groups were statistically significant （both P〈0.05）.Conclusion The ERUS features of CRP are found to be diffuse thickening of the involved rectal wall with increased blood flow signals.

关 键 词：慢性放射性直肠炎 经直肠 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R818[医药卫生—诊断学]