对比MRI与直肠腔内超声诊断直肠阴道瘘  

Comparison of MRI and endorectal ultrasonography in diagnosis of rectovaginal fistula

作　　者：林静 张文静 覃斯 刘小银[1] 陈瑶[1] 余俊丽[1] 王怡敏[1] 刘广健[1] LIN Jing;ZHANG Wenjing;QIN Si;LIU Xiaoyin;CHEN Yao;YU Junli;WANG Yimin;LIU Guangjian(Department of Ultrasound,the Sixth Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院超声科,广东广州510655

出　　处：《中国医学影像技术》2020年第5期716-719,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的对比分析MRI和直肠腔内超声(ERUS)诊断直肠阴道瘘(RVF)的应用价值。方法回顾性分析51例术前MRI和ERUS疑诊RVF患者,分别根据病因及复杂程度对瘘管进行分类;以手术结果为标准,比较MRI与ERUS诊断RVF的敏感度、特异度、准确率及其对各种类型RVF的检出率,分析MRI、ERUS诊断结果与手术结果的一致性以及MRI与ERUS二者之间诊断结果的一致性。结果经手术证实40例存在RVF。MRI诊断RVF的敏感度、特异度、准确率(85.00%、90.90%、86.27%)与ERUS(80.00%、100.00%、84.31%)相比差异均无统计学意义(χ^2=0.17、<0.01、<0.01,P均>0.05)。MRI、ERUS诊断结果与手术结果的一致性均较高(Kappa=0.65、0.63,P均<0.05);二者之间诊断结果的一致性亦较高(Kappa=0.70,P<0.05)。MRI及ERUS对单纯性瘘的检出率均为100%,对复杂性瘘的检出率差异无统计学意义(χ^2=0.17,P=0.69);2种方法相结合,对复杂性瘘的检出率提高至88.57%(31/35)。MRI与ERUS对不同病因所致RVF检出率差异无统计学意义(P均>0.05)。结论MRI及ERUS均可用于诊断RVF。对单纯性RVF建议以ERUS为首选检查方式。对于复杂性RVF,联合应用二者可提高检出率。Objective To compare the value of MRI and endorectal ultrasonography(ERUS)in diagnosis of rectovaginal fistula(RVF).Methods Data of 51 patients with suspected RVF who underwent preoperative MRI and ERUS were retrospectively analyzed.Then all RVFs were classified according to the cause and complexity,respectively.Taken surgical operation outcomes as standards,the sensitivity,specificity and accuracy of MRI and ERUS in diagnosis of RVF were evaluated,and the detection rate of MRI and ERUS for various types of RVF were compared and analyzed.The consistency of MRI and ERUS diagnosis results with surgical results,also between MRI and ERUS diagnosis results were analyzed.Results RVF were confirmed in 40 cases with surgical operation.No statistical difference of the sensitivity,specificity and accuracy of MRI(85.00%,90.90%,86.27%)nor ERUS(80.00%,100%,84.31%)with surgical operation was found(χ^2=0.17,<0.01,<0.01,all P>0.05).Strong consistency of MRI and ERUS diagnostic results were found with surgical diagnosis(Kappa=0.65,0.63,both P<0.05)and between ERUS and MRI(Kappa=0.70,P<0.05).The detection rate of MRI and ERUS for simple fistula were both 100%,while there was no significant difference in the detection rate of MRI and ERUS for complicated fistula(χ^2=0.17,P=0.69).The detection rate for complex fistula increased to 88.57%(31/35)with the combination of MRI and ERUS.There was no statistically difference of the detection rate of MRI and ERUS among RVFs with different causes(all P>0.05).Conclusion Both MRI and ERUS can be used to diagnose RVF.ERUS is recommended as the preferred examination for simple RVF,while the combination of MRI and ERUS can improve the detection rate of complex RVF.

关 键 词：直肠阴道瘘 腔内超声检查 磁共振成像 诊断 

分 类 号：R574.63[医药卫生—消化系统] R445[医药卫生—内科学]