端扫式凸阵腔内探头经会阴超声术前定位男性肛瘘内口

目的 探讨端扫式腔内凸阵探头经会阴超声在男性肛瘘患者肛瘘内口术前定位中的应用价值。方法 对36例男性肛瘘患者术前行超声检查，以频率为3~10 MHz的端扫式腔内探头经会阴超声扫查肛周括约肌及周围组织，观察肛瘘内口的位置和大小；以频率为5~12 MHz的高频线阵探头扫查肛瘘外口和瘘管，并与手术结果对照。结果 端扫式经会阴超声检查均可清晰显示肛周内外括约肌，内口表现为肛管纵行肌的高回声中断缺损，且中断缺损与低回声瘘管相延续。手术证实36例肛瘘患者共38个内口，术前超声共检出33个内口，漏诊3例单纯性肛瘘的3个内口、1例复杂性肛瘘2个内口中的1个，并将1例单纯性肛瘘内口误诊为正常走行的腺管；经会阴部端扫式超声诊断肛瘘内口的符合率为86.84%（33/38）。高频线阵探头超声诊断肛瘘外口和瘘管的符合率为97.22%（35/36）。结论 端扫式凸阵腔内探头经会阴超声术前定位男性肛瘘内口无创、便捷，具有较高价值。

End-fire endoprobe transperineal sonography in preoperative localizing of anal fistula internal opening in males

Objective To observe the application value of end-fire endoprobe transperineal sonography in preoperative localizing internal opening of anal fistula in males.Methods Totally 36 male patients with anal fistula underwent preoperative ultrasonography with an end-fire probe of 3-10 MHz transperineally to localize the internal opening, and with a linear transducer of 5-12 MHz to observe external opening and fistula. The results were compared with surgical findings.Results Both internal and external anal sphincters were clearly shown with ultrasound in all patients, and the internal opening was demonstrated as defect in the external anal of high echoes with end-fire endoprobe, and the defect continued to the fistula of low echoes. In 36 patients, there were 38 internal openings confirmed with surgical operation, and 33 were detected with ultrasonography. Three openings in 3 simple fistula patients and 1 of 2 internal openings in 1 complex fistula patient were missed, and 1 opening was misdiagnosed as a normal anal gland. The diagnostic accuracy of end-fire transperineal sonography was 86.84% (33/38). The accuracy of high frequency ultrasound in locating the external opening and fistula was 97.22% (35/36).Conclusion The end-fire endoprobe transperineal sonography is simple and noninvasive, therefore being valuable in preoperative locating internal opening of anal fistula in males.