经会阴三维超声检查联合Sonazoid瘘管造影对肛瘘的诊断价值  

Value of Sonazoid enhancement of three-dimensional transperineal ultrasound in fistula-in-ano

作　　者：杨军 张志轶 沈文龙 韩松 刘志强 袁航 YANG Jun;ZHANG Zhiyi;SHEN Wenlong;HAN Song;LIU Zhiqiang;YUAN Hang(Department of Anorectal Surgery,Qilu Hospital(Qingdao),Cheeloo College of Medicine,Shandong University,Qingdao 266035,China;Department of Ultrasound in Medicine,Qilu Hospital(Qingdao),Cheeloo College of Medicine,Shandong University,Qingdao 266035,China)

机构地区：[1]山东大学齐鲁医院(青岛)肛肠科,山东青岛266035 [2]山东大学齐鲁医院(青岛)超声科,山东青岛266035

出　　处：《医学影像学杂志》2024年第11期105-108,共4页Journal of Medical Imaging

基　　金：山东省青岛市卫生健康委员会临床重点专科建设项目(编号:QDZDZK-2022098)。

摘　　要：目的探讨经会阴三维超声检查联合Sonazoid瘘管造影对肛瘘患者的诊断价值。方法45例肛瘘手术患者,术前均行经会阴三维超声检查联合Sonazoid瘘管造影,以手术结果为金标准,对比分析两者在肛瘘分类、分型、支管、内口位置的诊断准确率。术后随访1年,记录治愈率及复发情况。结果手术结果显示45例患者中17例患者为括约肌间瘘(37.8%),25例为经括约肌瘘(高位9例,低位16例;占55.6%),2例为括约肌上瘘(4.4%),1例为括约肌外瘘(2.2%)。45例患者共有57个内口、16个支管。经会阴三维超声和Sonazoid瘘管造影诊断瘘管Park's分型的准确率差异无统计学意义(χ^(2)=0.45,P=0.502);对肛瘘复杂性分类的准确率差异有统计学意义(χ^(2)=4.05,P=0.044);对内口定位的准确率差异有统计学意义(χ^(2)=5.509,P=0.019);对检测肛瘘支管的准确率差异有统计学意义(P=0.037)。结论经会阴三维超声联合Sonazoid瘘管造影检查能够对肛瘘进行准确的分型、分类,并进一步提高肛瘘支管及内口定位的准确率,具有较高的诊断价值。Objective To evaluate the value of Sonazoid enhancement of tridimensional transperineal ultrasound(SNZ 3DTPUS)in diagnosing fistula-in-ano.Methods We studied 45 cases of fistula-in-ano who underwent Sonazoid enhancement of 3D-TPUS(SNZ 3D-TPUS).Comparing the results with surgical findings,considered as reference standard,we calculated the diagnostic accuracy of Park's classification,staging of fistulas,branches and site of internal openings.The follow-up in this study was 12 months.Results Surgical results showed that 17 patients had the inter-sphincteric(37.8%),25(9 high and 16 low)had the trans-sphincteric(55.6%),2 were supra-sphincteric fistulas(4.4%)and 1 was extra-sphincteric fistula(2.2%).There were 57 internal openings and 16 branches in 45 patients.There was significant difference in the accuracy of 3D-TPUS and SNZ 3D-TPUS in internal opening evaluation(χ^(2)=5.509,P=0.019).There was no significant difference in the accuracy of 3D-TPUS and SNZ 3D-TPUS in fistula Park's classification(χ^(2)=0.45,P=0.502).There was significant difference in the accuracy of 3DTPUS and SNZ 3D-TPUS in complexity classification(χ^(2)=4.05,P=0.044).There was significant difference in the accuracy of 3DTPUS and SNZ 3D-TPUS in detecting branches(P=0.037).Conclusion 3D-TPUS may be considered as a helpful investigation for patients with perianal fistulas because of high accuracy with intra-operative findings.In complex fistula-in-ano,Sonazoid enhancement of 3D-TPUS is proved more accurate for exploring fitula branches and internal openings than 3D-TPUS.It may be valuable in difficult cases.

关 键 词：经会阴超声检查 超声造影 肛瘘 

分 类 号：R445.1[医药卫生—影像医学与核医学] R657.16[医药卫生—诊断学]