Gravante Gianpiero, De Simone Veronica, Sorge Roberto, Picciariello Arcangelo, Sileri Pierpaolo, Gallo Gaetano
Department of General Surgery, Azienda Sanitaria Locale ASL Lecce, Casarano, Italy.
Colorectal Surgery Unit, IRCCS San Raffaele Scientific Institute, Faculty of Medicine and Surgery, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy.
Int J Colorectal Dis. 2025 Sep 19;40(1):202. doi: 10.1007/s00384-025-04951-5.
To evaluate arterial flow patterns in healthy individuals and patients with hemorrhoidal disease (HD) using Doppler transperineal ultrasound (TPUS), aiming to clarify the vascular contribution to HD pathophysiology.
A prospective observational study was conducted on 50 healthy controls (HC) and 94 HD patients classified by Goligher grade. All underwent TPUS with Doppler assessment to record vascular patterns and quantify peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI).
A vascular Doppler pattern was observed in 92.6% of HD patients vs. 50% of HCs (p < 0.001). HD patients showed significantly higher PSV (11.1 ± 3.6 cm/s vs. 8.3 ± 2.9 cm/s, p < 0.001) and RI (0.8 ± 0.1 vs. 0.7 ± 0.1, p = 0.015), with no significant difference in EDV. Among Goligher groups, grades III and IV showed significantly elevated PSV compared to HCs. No differences were observed in EDV or RI among subgroups.
Doppler TPUS can identify distinct hemodynamic profiles in HD patients, supporting a vascular component in HD pathogenesis. Its ability to detect subclinical alterations and distinguish severity grades may enhance diagnostic accuracy and guide tailored treatment strategies.
使用多普勒经会阴超声（TPUS）评估健康个体和痔病（HD）患者的动脉血流模式，旨在阐明血管因素在HD病理生理学中的作用。
对50名健康对照者（HC）和94名按戈利格尔分级的HD患者进行了一项前瞻性观察研究。所有人都接受了TPUS检查及多普勒评估，以记录血管模式并量化收缩期峰值流速（PSV）、舒张末期流速（EDV）和阻力指数（RI）。
92.6%的HD患者观察到血管多普勒模式，而HC中这一比例为50%（p < 0.001）。HD患者的PSV（11.1±3.6 cm/s对8.3±2.9 cm/s，p < 0.001）和RI（0.8±0.1对0.7±0.1，p = 0.015）显著更高，EDV无显著差异。在戈利格尔分级组中，III级和IV级的PSV与HC相比显著升高。各亚组的EDV或RI无差异。
多普勒TPUS可识别HD患者不同的血流动力学特征，支持血管因素在HD发病机制中的作用。其检测亚临床改变和区分严重程度分级的能力可能提高诊断准确性并指导个性化治疗策略。
