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三维肛管及直肠内超声在肛瘘诊断中的应用

[Application of three-dimensional endoanal and endorectal ultrasound in the diagnosis of anorectal fistula].

作者信息

Li Tao, Ding Ke, Wang Jian-xin, Lü Yan-feng, Zhao Zhi-lun, Bei Shao-sheng, Yu Hua-long

机构信息

Department of Anorectal Surgery, the Second Hospital of Shandong University, Jinan, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2010 Aug 15;48(16):1210-3.

Abstract

OBJECTIVE

To evaluate the efficacy of three-dimensional anal and endorectal ultrasound in identifying the internal opening and tracing the tract of the anorectal fistula.

METHODS

From November 2008 to January 2010, 127 patients suffering anorectal fistula were managed with three-dimensional endoanal and endorectal ultrasound. The internal opening, the tract of the fistula and fistula trace were identified by the ultrasonography with three-dimensional imaging. All results were confirmed and compared with findings from the operation.

RESULTS

The internal opening of the fistula was specified in 116 patients, the accuracy rate was 91.3% (116/127). The internal opening of the fistula was located above the dentate line in 112 patients, and located in rectal ampulla in 4 patients. The main fistula tract was identified in all the patients, the accuracy rate was 100%. In this group, the fistula tunneled as follows: trans-sphincteric in 47 patients, intersphincteric in 75 cases, supra sphincteric in 2 cases, extra sphincteric in 3 patients. Secondary extension was found in 37 patients, the accuracy rate was 100% (37/37).

CONCLUSIONS

Three-dimensional anal and endorectal ultrasound is an effective way for localizing the internal opening and the tract of anorectal fistula. It can provide valuable information for curative operation.

摘要

目的

评估三维肛管及直肠内超声在识别肛瘘内口及追踪肛瘘瘘管方面的有效性。

方法

2008年11月至2010年1月,对127例肛瘘患者采用三维肛管及直肠内超声进行检查。通过三维成像超声检查来识别肛瘘的内口、瘘管及瘘管走行。所有结果均经手术证实并与手术 findings 进行比较。

结果

116例患者明确了肛瘘内口,准确率为91.3%(116/127)。112例患者肛瘘内口位于齿状线以上,4例位于直肠壶腹。所有患者均识别出主要瘘管,准确率为100%。该组中,瘘管走行如下:经括约肌型47例,括约肌间型75例,括约肌上型2例,括约肌外型3例。37例患者发现有分支延伸,准确率为100%(37/37)。

结论

三维肛管及直肠内超声是定位肛瘘内口及瘘管的有效方法。它可为根治性手术提供有价值的信息。

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