Preoperative assessment of fistula-in-ano using SonoVue enhancement during three-dimensional transperineal ultrasound  

作　　者：Jun Yang Qing Li Hua Li Heng Zhang Donglin Ren Zhiyi Zhang Dan Su Haihua Qian 

机构地区：[1]Department of Anorectal Surgery,The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu,P.R.China [2]Department of Anorectal Surgery,Qilu Hospital(Qingdao),Cheeloo College of Medicine,Shandong University,Qingdao,Shandong,P.R.China [3]Department of Anorectal Surgery,Xingtai People’s Hospital,Hebei Medical University,Xingtai,Hebei,P.R.China [4]Department of Surgical Oncology,Xingtai People’s Hospital,Hebei Medical University,Xingtai,Hebei,P.R.China [5]Department of Colorectal and Anal Surgery,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China [6]Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China [7]Biomedical Innovation Center,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China [8]Department of Ultrasound in Medicine,Qilu Hospital(Qingdao),Cheeloo College of Medicine,Shandong University,Qingdao,Shandong,P.R.China

出　　处：《Gastroenterology Report》2024年第1期63-68,共6页胃肠病学报道(英文)

基　　金：supported by the Foundation of Qingdao Key Health Discipline Development Fund[grant number QDZDZK-2022098];the Hebei Province 2020 Annual Medical Science Research Project[grant number 20201578];the National Natural Science Foundation of China[grant number 82305243].

摘　　要：Background:Accurate preoperative evaluation of fistula-in-ano can guide the choice of surgical procedure and may improve healing rates.This prospective study aimed to evaluate the accuracy of conventional 3D transperineal ultrasound(3D-TPUS)compared with SonoVue(SVE)-enhanced 3D-TPUS for the detection and classification of anal fistula.Methods:In this prospective study,3D-TPUS reconstructions were performed before and after SVE enhancement in 60 patients with fistula-in-ano who intended to undergo surgery at the Department of Anorectal Surgery,Qilu Hospital,Cheeloo College of Medicine,Shandong University(P.R.China)between January 2021 and October 2021.Accuracies of anal fistula classification,complexity classification,detection of anal fistula branches,and detection of internal opening between 3D-TPUS and SVE 3D-TPUS were compared based on a reference standard-intraoperative findings.Results:This study enrolled 60 patients(mean age,37.1±11.4years;mean follow-up,9±3months).Intraoperative findings showed that the fistula type was intersphincteric in 23 patients(38.3%),trans-sphincteric in 35(58.3%;12 high and 23 low),and suprasphincteric in 2(3.3%).Moreover,68 internal openings were found.Compared with the accuracy of 3D-TPUS,that of SVE 3D-TPUS was similar in fistula classification[95.0%(57/60)vs 96.7%(58/60),P=0.392],but significantly higher in internal opening evaluation[80.9%(55/68)vs 97.1%(66/68),P=0.001],complexity classification[85.0%(51/60)vs 98.3%(59/60),P=0.018],and detection of fistula branches[70.4%(19/27)vs 92.6%(25/27),P=0.031].Conclusions:SVE 3D-TPUS may be a useful examination for patients with perianal fistulae because of its high accuracy and consistency with intraoperative findings,especially in complex fistula-in-ano and difficult cases.

关 键 词：FISTULA-IN-ANO transperineal ultrasound SONOVUE ENHANCEMENT 

分 类 号：R657.1[医药卫生—外科学]