高频线阵及经直肠腔内超声对肛瘘及肛周脓肿的诊断价值

目的探讨利用超声高频线阵探头经肛周和腔内探头经直肠检查肛瘘及肛周脓肿的诊断价值。方法使用ATL超9及Philip HD11XE型彩色多普勒超声诊断仪的5-10MHz高频线阵探头经肛周结合5-9MHz腔内探头,经直肠对43例肛瘘患者进行检查。其中26例进行了手术治疗,检查结果与手术结果进行对比。结果对43例肛瘘患者外口（位置、距肛门距离、数目）、走行（曲直、方向、长度）、内口（是否可见,内口距肛门口的距离）、主管和支管（数目、与括约肌、肛提肌的关系以及走行的方向）、肛周脓肿（有无、范围、位置、数目）等进行详细观测和描述。按照检查结果依据肛瘘诊断标准,超声诊断低位单纯型22例、低位复杂型8例、高位单纯型5例、高位复杂型8例。对26例手术患者诊断主管的敏感度92.3%,漏诊率7.7%;诊断支管的敏感度91.7%,漏诊率8.3%,特异度100%。结论超声诊断能为肛瘘和肛周脓肿提供详细的影像学资料,具有较高的临床应用价值。

High-frequency linear array and transrectal ultrasound in the diagnosis of anal fistula and abscesses

Objective To discuss the diagnostic value of fistula in anal by high-frequency linear array (HFLA) and transrectal ultrasound (TRUS). Methods Forty-three patients with anal fistula were performed regular ultrasound; 26 of them were taken before operation. The accuracy of TRUS and HFLA were compared with a reference standard derived from surgical findings. Results All the 43 patients had been observed clearly by high-frequency linear array and transrectal ultrasound, including: external opening (location, distance to anal, number),fistulous tracts (way, directing, length), locate internal opening (visible or invisible, distance to anal), internal main tract and secondary tract (number, connection to sphincters and levator muscle, directing). Using the criteria, we found low simple 22 cases, high simple 5 cases, low complex 8 cases, high complex 8 cases. The sensitivity (Se), false negative (Fn) value of main tract were 92.3%, 7.7%. The sensitivity (Se), false negative (Fn) and specificity (SP) value secondary tracts were 91.7%, 8.3%, 100%. Conclusion Ultrasound can offer detailed imaging of anal fistula and abscesses and accordingly has high clinical value.