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
杨军 1张志轶 2沈文龙 1韩松 1刘志强 1袁航1
作者信息
- 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
- 折叠
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(χ2=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(χ2=4.05,P=0.044);对内口定位的准确率差异有统计学意义(χ2=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.
Abstract
Objective To evaluate the value of Sonazoid enhancement of tridimensional transperineal ultrasound(SNZ 3D-TPUS)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 di-agnostic 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(χ2=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(χ2=0.45,P=0.502).There was significant difference in the accuracy of 3D-TPUS and SNZ 3D-TPUS in complexity classification(χ2=4.05,P=0.044).There was significant difference in the accuracy of 3D-TPUS and SNZ 3D-TPUS in detecting branches(P=0.037).Conclusion 3D-TPUS may be considered as a helpful investiga-tion 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Key words
Transperineal ultrasound/Sonazoid enhancement/Fistula-in-ano引用本文复制引用
出版年
2024
NETL
NSTL
万方数据