经会阴灰阶和彩色多普勒超声联合诊断肛周炎性疾病的准确性研究

目的：评价经会阴灰阶和彩色多普勒超声联合对肛周炎性疾病诊断的准确性。方法：采用前瞻性研究方法，对97名怀疑患有肛周炎性疾病的病人采用线阵探头（4～7MHz）进行了检查，并对病变部位图像的形态特征及范围进行了评估，同时采用彩色多普勒超声对病变部位新生血管情况进行了检测，并采用Logistic回归方法对数据进行了分析，以确认彩色多普勒的辅助诊断意义。超声检查结果以手术探查结果作为标准进行了比较。结果：在73例接受手术的病人中证实了107处肛周炎性病变。灰阶超声对肛周炎性疾病的发现及病变性质的诊断与手术探查结果具有显著的一致性（r=0．67，P〈0．01）。灰阶和彩色多普勒超声联合检查的准确性较单一方法检查方法有显著提高。同时炎性病变周围血运增加情况可以作为肛周炎性疾病诊断的独立特征性指征。结论：经会阴灰阶和彩色多普勒超声联合检查能为临床提供更高综合性影像特征信息，提高肛周脓肿和肛瘘的正确诊断率。

Accuracy of Transperineal Combined Gray Scale and Color Doppler Sonography to Diagnose Perianal Inflammatory Diseases

Objective:To evaluate the accuracy of transperin eal gray scale and color Doppler sonography for the detection and characterizati on of perianal inflammatory diseases.Methods:From October, 2001 to January, 2004, 97 patients withsuspe cted perianal inflammatory disorders underwent transperineal gray scale and colo r Doppler sonography with a linear 4 to 7 MHz transducer that was used to scan t he entire perianal region to detect and evaluate the disorder's morphologic char acteristics and extent. Color Doppler sonography was applied to assess the prese nce of increased vascularity around the suspected region. The sonographic result s were compared with the results of operational exploration that used as standa r d. Logistic regression analysis was used to assess whether increased regional va scularity was a characteristically predictive factor of perianal inflammatory di seases. Results:One hundred and seven perianal inflammatory disorderswere confi rmed in 73 patients. Gray scale sonography performed a significantly good agreem ent with the operational results in the detection and characterization of perian al inflammatory diseases (r=0.67,P<0.01). Combined gray scale and colorDopplersonography increased the diagnostic confidence significantly compared with singl e method applied. Meanwhile hypervascularity around the suspected diseased regio n could be used as a independent predictor of an inflammatory disease. Conclusion:Combined gray scale and color Doppler sonography ca n provide comprehensive information to enable a high detectability rate and char acterization of perianal fistulas and abscesses.