本文選題：直腸瘺　切入點(diǎn)：超聲檢查　出處：《中國醫(yī)學(xué)影像學(xué)雜志》2016年02期

【摘要】：目的探討實(shí)時三維超聲在肛瘺內(nèi)口定位、術(shù)前評估和指導(dǎo)手術(shù)中的應(yīng)用價值。資料與方法回顧性分析經(jīng)手術(shù)確診為肛瘺的142例患者的超聲資料,術(shù)前均行二維超聲和三維超聲檢查,分析三維超聲圖像特征及診斷肛瘺的分型與準(zhǔn)確率,比較二維超聲與三維超聲診斷肛瘺內(nèi)口位置、瘺管主管及支管走行的準(zhǔn)確率。結(jié)果142例患者中,低位單純性肛瘺25例,低位復(fù)雜性肛瘺15例,高位單純性肛瘺20例,高位復(fù)雜性肛瘺82例。三維超聲對肛瘺不同分型診斷準(zhǔn)確率均為100.0%。三維超聲診斷肛瘺內(nèi)口、主管、支管準(zhǔn)確率分別為95.0%(135/142)、100.0%(97/97)、90.7%(88/97),與二維超聲的82.3%(117/142)、93.8%(91/97)、69.0%(67/97)比較,差異均有統(tǒng)計學(xué)意義(P0.05、P0.01)。結(jié)論三維超聲能準(zhǔn)確定位肛瘺內(nèi)口,清晰顯示瘺管整體的空間形態(tài),提供比較直觀的瘺管的空間結(jié)構(gòu),是診斷肛瘺的有效輔助檢查方法,具有較高的臨床實(shí)用價值。
[Abstract]:Objective to evaluate the value of real-time three-dimensional ultrasound in the localization of internal orifice of anal fistula, and to evaluate and guide the operation before operation. Materials and methods the ultrasonographic data of 142 patients with anal fistula confirmed by operation were retrospectively analyzed. Two-dimensional ultrasound and three-dimensional ultrasound were performed before operation. The characteristics of three-dimensional ultrasound images and the classification and accuracy of diagnosis of anal fistula were analyzed, and the location of internal anal fistula was compared between two-dimensional ultrasound and three-dimensional ultrasound. Results among 142 patients, there were 25 cases of low simple anal fistula, 15 cases of low complex anal fistula and 20 cases of high simple anal fistula. There were 82 cases of high complex anal fistula. The accuracy of three dimensional ultrasound in the diagnosis of different types of anal fistula was 100.00.The accuracy of three dimensional ultrasound in the diagnosis of anal fistula internal cavity, supervisor and branch canal was 95.00.05 / 142, 100.097 / 97 / 90.788 / 97 / 97 respectively, compared with 82.33.3 / 93. 891 / 97 / 93. 891 / 97 / 99.97 / 97 of two-dimensional ultrasound. Conclusion Three-dimensional ultrasound can accurately locate the internal orifice of anal fistula, clearly display the spatial form of fistula, provide a more intuitive spatial structure of fistula, and is an effective auxiliary examination method for the diagnosis of anal fistula. It has high clinical practical value.
【作者單位】： 復(fù)旦大學(xué)附屬閔行醫(yī)院(上海市閔行區(qū)中心醫(yī)院)超聲科;上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院超聲科;復(fù)旦大學(xué)附屬閔行醫(yī)院(上海市閔行區(qū)中心醫(yī)院)肛腸科;
【基金】：上海市閔行區(qū)自然科學(xué)研究課題(2012MHZ023)
【分類號】：R445.1;R657.16
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本文編號：1654673