Bonatti H, Lugger P, Hechenleitner P, Oberwalder M, Kafka-Ritsch R, Conrad F, Aigner F, Mallouhi A, Bodner G
Klinische Abteilung für Allgemeine Chirurgie, Klinische Abteilung für Radiodiagnostik I, Universitätsklinik Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
Ultraschall Med. 2004 Apr;25(2):111-5. doi: 10.1055/s-2004-813100.
Magnetic resonance imaging, computed tomography, endorectal and endoanal sonography are used for imaging of inflammatory and neoplastic conditions of the lower rectum, the anus and the perineum. These methods, however, have their limitations regarding accuracy, cost-effectiveness, and availability in the acute setting. Pain may be a limiting factor when introducing a probe into the anus. Percutaneous transperineal sonography is an acknowledged method for diagnosing anorectal malformations in children and infants and for diagnosis of prostatic disease. Until today, only limited reports regarding the value of transperineal sonography for evaluation of diseases of the lower rectum, the anus and the perianal region in adults are available.
Between 1997 and 2000 a total of 44 patients underwent transperineal sonography including B-mode and colour Doppler sonography for imaging anorectal structures using 3.5 MHz sector arrays and 7 MHz linear arrays. The lesions were also investigated using colour Doppler imaging. During examination the patient is positioned on his side. Orientation landmarks are the pubic symphysis and the prostate gland in men and the vagina in women.
The spectrum of diseases of the current study population (44) included perianal fistulas (10), pararectal abscesses (7), fistulas with abscess (7), perianal inflammation without abscess (1), rectal (6) and anal carcinomas (3) and metastasis of a leiomyosarcoma (1). In 10 cases digital examination of the anus and rectum was not possible because of intense pain. In 34 patients (85 %) sonographic findings were confirmed by intraoperative diagnosis.
Transperineal sonography proved to be an inexpensive, easily available diagnostic tool that may help in detecting a variety of pathological conditions of the lower rectum, the anus, and the perianal region.
磁共振成像、计算机断层扫描、直肠内超声和肛门内超声用于对直肠下段、肛门和会阴的炎症性及肿瘤性疾病进行成像。然而，这些方法在准确性、成本效益以及急性情况下的可及性方面存在局限性。将探头插入肛门时，疼痛可能是一个限制因素。经皮经会阴超声检查是诊断儿童和婴儿肛门直肠畸形以及前列腺疾病的公认方法。迄今为止，关于经会阴超声检查在评估成人直肠下段、肛门和肛周区域疾病价值的报道有限。
1997年至2000年间，共有44例患者接受了经会阴超声检查，包括B型超声和彩色多普勒超声，使用3.5MHz扇形探头和7MHz线性探头对肛门直肠结构进行成像。还使用彩色多普勒成像对病变进行了研究。检查时患者侧卧位。男性的定位标志是耻骨联合和前列腺，女性是阴道。
本研究人群（44例）的疾病谱包括肛周瘘（10例）、直肠旁脓肿（7例）、伴有脓肿的瘘（7例）、无脓肿的肛周炎症（1例）、直肠癌（6例）和肛管癌（3例）以及平滑肌肉瘤转移（1例）。10例患者因剧痛无法进行肛门和直肠指诊。34例患者（85%）的超声检查结果经术中诊断得到证实。
经会阴超声检查被证明是一种廉价、易于获得的诊断工具，有助于检测直肠下段、肛门和肛周区域的各种病理状况。
