摘要
目的 探讨彩色多普勒超声(color doppler ultrasound,CDU)在先天性耳前瘘管(congenital preauricular fistula,CPF)中的诊断、鉴别诊断价值.方法 回顾性选取2010年2月—2021年2月经舟山医院外科手术证实,同时经CDU检查的117例CPF患者的病例资料,分析超声报告所描述的内容与患者手术病程记录及病理结果进行对比,分析其准确率,以病理信息为标准,进行统计学一致性检验.结果 117例CPF感染患者中,32例有2～4个分支,CDU在CPF的主管走形及内口盲端显示准确率均为95.7%(112/117),差异有统计学意义(r=0.429,P<0.01);分支走形准确率56.3%(18/32),差异无统计学意义(r=0.071,P=0.279).CDU结果显示,CPF侵及耳软骨膜32例,准确率为69.6%(32/46),差异无统计学意义(r=0.088,P=0.146);与颞筋膜关系准确率为100%,差异有统计学意义(r= 1.000,P<0.01).CDU结果显示,CPF病灶周围动脉血管准确率为74.7%(62/83),差异无统计学意义(r=0.065,P= 0.094);静脉血管准确率为65.4%(34/52),差异无统计学意义(r=0.066,P=0.183).结论 CDU能清晰显示CPF主管、内口盲端走形及与颞筋膜关系,但对周边有无大血管及与耳软骨膜的关系一致性较差,在疾病鉴别诊断中具有重要的临床价值,能为临床医师的手术及决策提供帮助.
Abstract
Objective To investigate the value of color Doppler ultrasound(CDU)in the diagnosis and differen-tial diagnosis of congenital preauricular fistula(CPF).Methods Data from 117 patients with surgically confirmed CPF from February 2010 to February 2021 were retrospectively reviewed,including ultrasound descriptions,surgical notes and pathological results,which were used as the standard for comparison.Results CPF consisted of 2～4 branches in 32 cases,and CDU descriptions were consistent to surgical findings in 112 cases(95.7%)(r=0.429 P<0.01)and consistent to actual branch courses in 18 cases(56.3%)(r=0.071,P=0.279).CDU correctly revealed perichondrium invasion by CPF in 32 of the 46 cases(69.6%)(r=0.088,P=0.146).CDU accurately described the relationship with the temporal fas-cia in all cases(r=1.000,P<0.01),with peripheral arteries in 74.7%(62/83)of the cases(r=0.065,P=0.094),with veins in 65.4%(34/52)of the cases(r=0.066,P=0.183).Conclusion CDU can reliably demonstrate the main tract of CPF,the course of blind tubes and their relationship to the temporal fascia,but not that with peripheral blood vessels or perichon-drium.CDU bears important values in the diagnosis of this diseases and can help clinicians in treatment decision making and surgery planning.
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