经会阴高频超声联合超声造影对肛周脓肿及瘘管形成中的应用价值  

Analysis of diagnostic value of perineal high-frequency ultrasound combined with contrast-enhanced ultrasound in perianal abscess and fistula formation

作　　者：陈碧华 邹文娟 王志兰 CHEN Bihua;ZOU Wenjuan;WANG Zhilan(Department of Ultrasound Medicine,First Affiliated Hospital of Fujian Medical University,Nanping 353000)

机构地区：[1]福建医科大学附属南平第一医院超声医学科,福建南平353000

出　　处：《医学影像学杂志》2023年第2期283-287,共5页Journal of Medical Imaging

基　　金：国家自然科学基金资助项目(编号:81870654)。

摘　　要：目的 探讨经会阴高频超声联合超声造影对肛周脓肿及瘘管形成中的诊断价值。方法 选取我院拟行手术治疗的肛周脓肿患者128例,术前均行经会阴高频超声联合超声造影检查,以术中所见及术后病理检查结果为金标准,运用受试者工作特征曲线(ROC),分析经会阴高频超声联合超声造影诊断肛周脓肿及瘘管形成的效能。结果 128例患者术中共发现病灶141枚,其中Ⅰ型56枚,Ⅱ型7枚,Ⅲ型28枚,Ⅳ型17枚,Ⅴ型33枚;病理分期:前期29枚,形成期82枚,后期30枚。经会阴高频超声检出病灶127枚,超声造影检出病灶141枚。经会阴高频超声与超声造影判断肛周脓肿分型的准确率分别为85.11%、97.16%,2种方法的准确率比较,差异有统计学意义(P<0.05)。经会阴高频超声与超声造影判断肛周脓肿病理分期的准确率分别为89.76%、98.58%,2种方法的准确率比较,差异有统计学意义(P<0.05)。经会阴高频超声联合超声造影诊断肛周脓肿的灵敏度、特异性、准确率、阳性预测值、阴性预测值均较单独诊断更高。结论 经会阴高频超声联合超声造影,或单独使用超声造影均可为肛周脓肿及瘘管形成的诊断提供可靠参考。Objective To analyze the diagnostic value of perineal high-frequency ultrasound combined with contrast-enhanced ultrasound in perianal abscess and fistula formation. Methods 128 patients with perianal abscess treated in our hospital from April, 2018 to December, 2021 were examined by perineal high-frequency ultrasound combined with contrast-enhanced ultrasound before operation. Taking the intraoperative findings and postoperative pathological results as the gold standard, receiver operating characteristic curve(ROC) was used to analyze the efficacy of perineal high-frequency ultrasound combined with contrast-enhanced ultrasound in the diagnosis of perianal abscess and fistula formation. Results 141 lesions were found in 128 patients during operation, including 56 lesions of type Ⅰ, 7 lesions of type Ⅱ, 28 lesions of type Ⅲ, 17 lesions of type Ⅳ and 33 lesions of type Ⅴ. Pathological staging showed 29 in early stage, 82 in formative stage and 30 in late stage. 127 lesions were detected by perineal high-frequency ultrasound and 141 lesions were detected by contrast-enhanced ultrasound. The accuracy rates of perineal high-frequency ultrasound and contrast-enhanced ultrasound in judging perianal abscess classification were 85.11% and 97.16%, respectively, and the difference was statistically significant(P<0.05). The accuracy of perineal high-frequency ultrasound and contrast-enhanced ultrasound in judging the pathological stage of perianal abscess was 89.76% and 98.58% respectively, and the difference was statistically significant(P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of perineal high-frequency ultrasound combined with contrast-enhanced ultrasound in the diagnosis of perianal abscess are higher than those of single diagnosis. Conclusion Periperineal high-frequency ultrasound combined with contrast-enhanced ultrasound or contrast-enhanced ultrasound alone can provide reliable reference for the diagnosis of perianal abscess and fistula.

关 键 词：超声检查 超声造影 肛周脓肿 瘘管 

分 类 号：R657.1[医药卫生—外科学] R445.1[医药卫生—临床医学]