高频探头联合端扫式凸阵腔内探头经会阴超声诊断肛瘘

目的 探讨高频探头联合端扫式凸阵腔内探头经会阴超声对肛瘘的诊断价值。方法 回顾性分析87例接受手术治疗的肛瘘患者，术前均采用频率5~12 MHz线阵探头超声结合触诊和视诊检查外口和瘘管，频率3~10 MHz端扫式凸阵腔内探头经会阴超声检查内口和瘘管，确定肛瘘类型，分析超声与手术结果的一致性。结果 87例中，手术诊断单纯型肛瘘73例、复杂型肛瘘14例，术中见93个内口，101个瘘管，94个外口。超声诊断66例肛瘘，漏诊15例，误诊6例，与手术结果的符合率为75.86%（66/87），Kappa值为0.344（P<0.001）。超声诊断肛瘘内口、瘘管及外口的准确率分别为80.65%（75/93）、83.17%（84/101）及87.23%（82/94），与手术结果一致性的Kappa值分别为0.298、0.407及0.626（P均<0.001）。结论 高频探头联合端扫式凸阵腔内探头经会阴超声检查有助于诊断肛瘘。

High frequency probe combined with end scan convex array intracavitary probe transperineal ultrasonography in diagnosing anal fistula

Objective To explore the value of high frequency probe combined with end scan convex array probe transperineal ultrasonography for diagnosis of anal fistula. Methods Data of 87 patients with anal fistula who underwent surgical treatment were retrospectively analyzed. All patients were examined with ultrasonography using 5-12 MHz linear array probe combining with palpation and visual examination for detection of external mouth and fistula before operation, also perineum ultrasound using 3-10 MHz end scan convex array probe for detection of internal mouth and typing and location of anal fistula. The consistency between results of ultrasound and surgical operation was analyzed. Results Among 87 patients, 73 cases were diagnosed as simple anal fistula and 14 as complex anal fistula, with a total of 93 internal mouths, 101 fistula canals and 94 internal mouths were detected with surgical operation. Ultrasound correctly diagnosed anal fistula in 66 patients, missed anal fistula in 15 cases and misdiagnosed 6 cases, the coincidence rate of ultrasound and operation was 75.86% (66/87), the Kappa value was 0.344 (P<0.001).The accuracy of ultrasonography in diagnosing internal mouth, fistula canal and external mouth of anal fistula was 80.65% (75/93), 83.17% (84/101) and 87.23% (82/94), respectively, the Kappa value of consistency with operation results was 0.298, 0.407 and 0.626, respectively (all P<0.001). Conclusion High frequency probe combined with end scan convex array probe transperineal ultrasonography is helpful to diagnosis of anal fistula.