三维直肠腔内超声诊断肛周感染性疾病的临床应用

目的    探讨三维直肠腔内超声在定位肛周感染性疾病中内口、瘘管走形、脓腔位置、隐匿灶的价值。方法    应用三维直肠腔内超声检查175例患者，其中肛瘘127例，肛周脓肿48例，根据其声像图特征进行内口定位、瘘管走行追踪及检测脓腔位置、隐匿灶。结果    定位内口151例，准确率达86.3%（151/175）；定位瘘管一条者90例，瘘管两条者37例；检测到55个脓肿病灶，其中皮下脓肿9例，黏膜下脓肿3例，黏膜皮下脓肿4例；低位肌间脓肿16例，高位肌间脓肿11例，坐骨直肠间隙脓肿3例，盆腔间隙脓肿2例。均经手术证实。结论    应用三维直肠腔内超声检查肛周感染性疾病，能够准确定位内口、显示瘘管走行，有效检测脓腔位置及隐匿灶，能为临床治疗方法的选择提供必要的诊断依据。

Clinical application of three-dimensional transrectal ultrasonography to the diagnosis of perianal infections

Objective    To evaluate the role of three-dimension transrectal ultrasonography in locating the internal opening,  trend of fistulas, pus-filled cavity and occult focus in diagnosing perianal infections.  Methods   127 cases of anal fistula and 48 cases of perianal abscess were examined by three-dimensional endoluminal ultrasonography.  According to the characters of the sonogram and echogram, it located the internal opening, traced the trend of fistulas, and detected the pus filled cavity′s location and the occult focus. Results    In 151 cases the internal opening was located with an accuracy rate of 86.3%（151/175）； in 90 cases one fistula was located, and in 37 cases two fistulas were located. 55 cases of abscess were examined, including 9 cases of sub-cutaneous abscess, 3 cases of sub-mucosal abscess, 4 cases of mucosa subcutaneous abscess, 16 cases of low intramuscular abscess, 11 cases of high intramuscular abscess, 3 cases of ischial rectal space abscess, and 2 cases of pelvic space abscess. All  the above were confirmed by surgery. Conclusion    Three-dimensional endoluminal ultrasonography in diagnosing perianal infections can accurately locate the internal opening, display the trend of fistulas, and effectually detect the pus-filled cavity′s location and the occult focus. And it can provide essential diagnostic criteria for choosing the clinical therapy method.