经会阴和经阴道三维肛外超声成像评估女性肛门括约肌的对比研究

通过经会阴和经阴道三维超声对比评估女性肛门括约肌，探讨不同肛外超声成像方式在评估女性肛门括约肌的应用价值。 方法 选取101例女性同时进行经会阴和经阴道三维超声检查对肛门括约肌进行成像，分别记为经会阴组和经阴道组。测量肛门内括约肌（IAS）和肛门外括约肌（EAS）在肛管横断面3、6、9、12点钟方向上的厚度，调节断层超声模式评估肛门括约肌损伤情况，记录结果并进行统计分析。 结果 IAS厚度测量值在肛管横断面12点钟方向上，经阴道组比经会阴组更薄，差异具有统计学意义（P<0.05）；EAS厚度测量值在肛管横断面6点、12点钟方向上，经阴道组比经会阴组更薄，差异具有统计学意义（P<0.05）。两组IAS及EAS测量值在肛管横断面全部4个方向上有良好的相关性且均具有统计学意义（P均<0.05）。经会阴组筛查出IAS损伤6例（5.94%），EAS损伤16例（15.84%），IAS合并EAS损伤13例（12.87%）；经阴道组筛查出IAS损伤8例（7.92%），EAS损伤17例（16.83%），IAS合并EAS损伤9例（8.91%）。两组在评估肛门括约肌损伤的一致性较好且具有统计学意义（Kappa=0.736，P<0.05） 结论 经会阴和经阴道三维超声在评估女性肛门括约肌具有较好的相关性和一致性，两者均为评估女性肛门括约肌良好的肛外超声成像方式。

Comparative study of transperineal and transvaginal three-dimensional ultrasound in the exoanal ultrasound imaging of female anal sphincter

To evaluate female anal sphincter by transperineal and transvaginal three-dimensional ultrasound, and to explore the application value of different exoanal ultrasound imaging methods in evaluating female anal sphincter. Methods Three-dimensional volume imaging of anal sphincter was performed by transperineal ultrasound (transperineal group) and transvaginal ultrasound (transvaginal group). The thickness of internal anal sphincter (IAS) and external anal sphincter (EAS) at 3 o''clock, 6 o''clock, 9 o''clock and 12 o''clock were measured, and the anal sphincter injury was evaluated by adjusting sectional ultrasound mode. the results were recorded and statistically analyzed. Results The measured value of IAS thickness at 12 o''clock was thinner in the transvaginal group than in the transperineal group, and the difference was statistically significant (P<0.05). The EAS thickness measurement value was thinner in the transvaginal group than the transperineal group at 6 o''clock and 12 o''clock, and the difference was statistically significant (P<0.05). The two groups of EAS and IAS measured values had good correlations in all 4 directions and all had statistical significance (P<0.05). 6 cases (5.94%) of IAS injury were detected, 16 cases (15.84%) of EAS injury, and 13 cases (12.87%) of EAS combined with IAS injury in the transperineal group. The corresponding data in the transvaginal group were 8 cases (7.92%), 17 cases (16.83%), and 9 cases (8.91%). The two groups had good consistency in evaluating anal sphincter injury and had statistical significance (Kappa=0.736, P<0.05). Conclusions Transperineal and transvaginal three-dimensional ultrasound have good correlation and consistency in the evaluation of female anal sphincter, both of which are good exoanal ultrasound imaging methods for evaluating female anal sphincter.