中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (09): 743-745.

• 论著 • 上一篇    下一篇

三维肛肠超声扫描结合瘘管造影定位诊断肛瘘临床研究

贝绍生，丁 克，王建新，禹化龙，吕艳锋，李 涛   

  1. 山东大学第二医院肛肠外科，山东济南 250033
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-09-01 发布日期:2009-09-01

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-09-01 Published:2009-09-01

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摘要：

目的 探讨三维肛肠超声（3D?endoanal ultrasound）扫描并结合瘘管双氧水造影对肛瘘进行定位诊断的临床应用价值。方法 2008年11月至2009年1月间山东大学第二医院对17例临床疑似为肛瘘的病人应用三维肛肠超声扫描和瘘管造影。将术前获取的影像学资料与肛瘘手术和随访结果进行比较。结果　17例均经三维肛肠超声证实为肛瘘，9例为单纯性肛瘘，8例为复杂性肛瘘，并经过手术证实，三维肛肠超声检查低位肛瘘7例，高位肛瘘10例，其中经括约肌瘘8例、括约肌间瘘1例、括约肌外瘘1例，均经过手术证实，肛肠专科检查将1例高位肛瘘误诊为低位肛瘘，三维肛肠超声结合造影对术前内口准确率分别为90.9%。三维肛肠超声瘘管三维图像可清晰显示瘘管的具体位置及其与肛管内外括约肌、肛提肌的关系，清晰显示瘘管的形态和走行特点。结论 三维肛肠超声结合瘘管造影是一种精确的对肛瘘进行定位诊断的检查方法，可以为手术提供有效依据。

关键词: 肛瘘, 三维肛肠超声, 定位诊断

Abstract:

Three-dimensional endoanal ultrasound for the locational diagnosis of anal fistula: a preliminary application study BEI Shao-sheng，DING Ke, WANG Jian-xin, et al．Department of Anorectal Surgy，the Second Hospital of Shandong University，Jinan 250033，China Corresponding author：DING Ke，E-mail：dingke@163.com Abstract Objective To evaluate the effectiveness and applied value of three-dimensional (3D)-Endoanal ultrasound combined with hydrogen peroxide angiography for the locational diagnosis of anal fistula. Methods 3D-endoanal ultrasound examination was performed in 17 patients with clinically suspected anal fistulas between November 2008 and January 2009 at the Second Hospital of Shandong University and results were compared with surgical findings. Results Seventeen patients were confirmed by 3D-endoanal ultrasound examination. Nine patients had simple fistulas. Eight patients had complex fistulas. At the same time 7 patients had low located fistulas, and 10 patients had high located fistulas including 8 patients with trsphincter fistulas, 1 patient with inter sphincter fistula and 1 patient with extra-sphincter fistula. All patients were confirmed by operation. But on surgery’s professional examination 1 case with high located fistulas was remisdiagnosed as low located fistulas.3D-Endoanal ultrasound had a accuracy of 90.9%. The 3D shape and track of fistula could be well shown the site of anal fistula and its relationship with the phincter complex and the levator animuscle. Conclusion 3D-Endoanal ultrasound examination combined with fistulography is a very effective and reliable method for the locational diagnosis of anal fistula.

Key words: anal fistula, 3D-endoanal ultrasound, locational diagnosis