二维超声结合实时三维成像技术在肛瘘诊断中的应用

摘要

Objective To evaluate the clinical value of the real-time three-dimensional ultrasound in the diagnosis of the fistula-in-ano.Methods One hundred and eighteen fistula-in-ano patients were examined using conventional and three-dimensional ultrasound,the stereotaxis of interal opening and the shape of the fistula-in-ano were analyzed.Then the diagnosis results of ultrasound were compared with the surgery and pathology.Results In 1 1 8 patients,the accuracy of preoperative identifying internal opening by two-dimensional ultrasound was 85%,and 95% for three-dimensional ultrasound with statistically significant difference (χ2 =6.679,P <0.05).For complex anal fistula,the diagnostic accuracy rates of main fistula tract by three-dimensional ultrasound (100%,82/82 )was higher than that by two-dimensional ultrasound(95%,78/82),the difference was statistically significant (χ2 =4.100,P <0.05 ).In 82 cases of complex anal fistula,the diagnostic accuracy of branch fistula tract by two-dimensional ultrasound was 70%(57/82 ),the accuracy using three-dimensional ultrasound was 89% (73/82 ),there was statistically significance (χ2 =9.499,P < 0.05 ).Conclusions Three-dimensional ultrasound can accurately locate the interal opening of fistula-in-ano and determine the shape of fistula-in-ano,which provided the most intuitive information for clinical treatment and had high practical value.%目的：探讨实时三维超声在肛瘘内口立体定位、显示瘘管走形中的应用价值。方法采用常规二维超声和实时三维超声检查118例肛瘘患者,对肛瘘进行内口立体定位,对瘘管走形进行跟踪观察,并与手术及病理相对照。结果术前肛瘘内口的二维超声诊断准确率为85%(100/118),三维超声诊断准确率为95%(112/118),三维超声诊断肛瘘内口准确率显著高于二维超声(χ2=6.679,P <0.05)。三维超声诊断复杂性肛瘘主管准确率100%(82/82)高于二维超声95%(78/82),差别有统计学意义(χ2=4.100,P <0.05)；二维超声诊断复杂性肛瘘支管准确率为70%(57/82),三维超声为89%(73/82),差别有统计学意义(χ2=9.499,P <0.05)。结论三维超声能更清晰地显示肛瘘内口的位置,准确定位内口及判断瘘管的走向,为临床提供更直观的资料,具有较高的实用价值。