经会阴三维容积超声联合二维高频超声在肛周脓肿内口和分型中的诊断价值
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摘要
目的:探讨经会阴三维容积超声联合二维高频超声对肛周脓肿的诊断价值。方法:选取2017年12月至2018年7月陕西中医药大学附属医院收治的76例肛周脓肿患者,均行经会阴三维容积超声联合二维高频超声检查,分析诊断结果,并与单独二维高频超声检查结果及手术病理结果进行对比。结果:76例患者中,三维容积超声联合二维高频超声诊断皮下脓肿(Ⅰ型)30例,黏膜下脓肿(Ⅱ型)4例,括约肌间脓肿(Ⅲ型)14例,坐骨直肠间隙脓肿及骨盆直肠间隙脓肿(Ⅳ型)5例,肛瘘形成(Ⅴ型)3例,肛管后间隙脓肿及直肠后间隙脓肿(Ⅵ型)20例,分型准确率为94%,内口符合率为95%。单纯二维高频超声诊断Ⅰ型30例,Ⅱ型3例,Ⅲ型7例,Ⅳ型4例,Ⅴ型3例,Ⅵ型23例,分型准确率为85%,内口符合率为88%。两种方法诊断肛周脓肿分型的准确率及内口符合率比较,差异均有统计学意义(均P<0.05)。结论:经会阴三维容积超声联合二维高频超声用于肛周脓肿术前检查,在判断内口位置和临床病理分型方面具有较高的准确性。
Objective:To investigate the diagnostic value of transperineal three-dimensional ultrasound combined with two-dimensional high-frequency ultrasound for perianal abscess.Methods:Transperineal three-dimensional ultrasound combined with two-dimensional high-frequency ultrasound was performed in 76 patients with perianal abscess.The diagnosis results were analyzed and compared with the results of two-dimensional high-frequency ultrasound and surgical results.Results:Of 76 patients with perianal abscess detected by transperineal three-dimensional volume ultrasound combined with two-dimensional high-frequency ultrasound,30 cases were diagnosed as subcutaneous abscess(typeⅠ),4 cases were diagnosed as submucous abscess(typeⅡ),14 cases were diagnosed as sphincter abscess(typeⅢ),5 cases were diagnosed as sciatic rectal abscess and pelvic rectal abscess(typeⅣ),3 cases were anal fistula formation(typeⅤ)and 20 cases were posterior anal canal abscess and posterior rectal space(typeⅥ).The classification accuracy was94%,and the detection rate of internal mouths was 95%.There were 30 cases of typeⅠ,3 cases of typeⅡ,7 cases of typeⅢ,3 cases of typeⅣ,3 cases of type V,and 23 cases of typeⅥ diagnosed by two-dimensional high-frequency ultrasound.The classification accuracy was 85%,and the detection rate of internal mouths was 88%.The classification accuracy and the detection rate of internal mouths between the two methods were statistically significant(P<0.05).Conclusion:Transperineal three-dimensional ultrasound combined with two-dimensional high-frequency ultrasound was valuable for the identification of internal mouths location and pathological classification of perianal abscess.
Objective:To investigate the diagnostic value of transperineal three-dimensional ultrasound combined with two-dimensional high-frequency ultrasound for perianal abscess.Methods:Transperineal three-dimensional ultrasound combined with two-dimensional high-frequency ultrasound was performed in 76 patients with perianal abscess.The diagnosis results were analyzed and compared with the results of two-dimensional high-frequency ultrasound and surgical results.Results:Of 76 patients with perianal abscess detected by transperineal three-dimensional volume ultrasound combined with two-dimensional high-frequency ultrasound,30 cases were diagnosed as subcutaneous abscess(typeⅠ),4 cases were diagnosed as submucous abscess(typeⅡ),14 cases were diagnosed as sphincter abscess(typeⅢ),5 cases were diagnosed as sciatic rectal abscess and pelvic rectal abscess(typeⅣ),3 cases were anal fistula formation(typeⅤ)and 20 cases were posterior anal canal abscess and posterior rectal space(typeⅥ).The classification accuracy was94%,and the detection rate of internal mouths was 95%.There were 30 cases of typeⅠ,3 cases of typeⅡ,7 cases of typeⅢ,3 cases of typeⅣ,3 cases of type V,and 23 cases of typeⅥ diagnosed by two-dimensional high-frequency ultrasound.The classification accuracy was 85%,and the detection rate of internal mouths was 88%.The classification accuracy and the detection rate of internal mouths between the two methods were statistically significant(P<0.05).Conclusion:Transperineal three-dimensional ultrasound combined with two-dimensional high-frequency ultrasound was valuable for the identification of internal mouths location and pathological classification of perianal abscess.
引文
[1]罗文平,刘凤华,王肖雁,等.高频超声联合腔内超声在诊断肛周脓肿中的应用[J].当代医学,2015,12(10):61-62.
[2]李玲华,高爽,李炯弘.三维直肠腔内超声诊断肛管直肠周围脓肿的应用价值[J].中国超声医学杂志,2016,32(5):461-463.
[3]CHO D Y.Endosonographic criteria for an internal opening of fistula-ano[J].Dis Colon Recturn,1999,42(4):515-518.
[4]徐飞,宋新江,章萍,等.三维超声联合三维断层超声显像和容积对比成像技术在肛瘘诊断及分类中的应用价值[J].中华医学超声杂志,2014,11(11):915-918.
[5]王本军,丁克.三维肛管直肠腔内超声在肛周脓肿诊治中的应用[J].中国中西医结合影像学杂志,2014,12(4):417-419.
[2]李玲华,高爽,李炯弘.三维直肠腔内超声诊断肛管直肠周围脓肿的应用价值[J].中国超声医学杂志,2016,32(5):461-463.
[3]CHO D Y.Endosonographic criteria for an internal opening of fistula-ano[J].Dis Colon Recturn,1999,42(4):515-518.
[4]徐飞,宋新江,章萍,等.三维超声联合三维断层超声显像和容积对比成像技术在肛瘘诊断及分类中的应用价值[J].中华医学超声杂志,2014,11(11):915-918.
[5]王本军,丁克.三维肛管直肠腔内超声在肛周脓肿诊治中的应用[J].中国中西医结合影像学杂志,2014,12(4):417-419.