短轴追踪扫查法在肛瘘经体表超声检查中的诊断价值

Diagnostic value of short axis tracking scanning in perianal ultrasonography of anal fistula

目的探讨短轴追踪扫查法在肛瘘经体表超声检查中的诊断价值。方法回顾性分析解放军总医院海南医院超声诊断科2019-10至2021-10经体表超声检查的617例肛瘘患者资料,对纳入完成长轴和短轴追踪扫查的炎性肛瘘者,比较长轴、短轴追踪扫查对肛瘘内口、主瘘管及支瘘管的诊断准确率。结果入组患者共75例,包含33例常规超声联合经瘘管超声造影。常规超声检查时,短轴追踪对内口的诊断准确率高于长轴追踪,差异有统计学意义(77.33%vs.34.67%,P<0.05);主瘘管和支瘘管的诊断准确率对比,长轴、短轴追踪差异均无统计学意义(主瘘管86.67%vs.85.33%;支瘘管44.12%vs.38.24%)。联合超声造影后,短轴追踪对内口的诊断准确率高于长轴追踪,差异有统计学意义(90.91%vs.66.67%,P<0.05);对主瘘管和支瘘管的诊断准确率上长轴与短轴追踪差异均无统计学意义(主瘘管87.88%vs.93.94%;支瘘管71.43%vs.66.67%)。结论经体表短轴追踪扫查可提高肛瘘的超声诊断准确率。

Objective To explore the diagnostic value of short axis tracking scanning in perianal ultrasonography for anal fistula.Methods The data of 617 patients with anal fistula who underwent perianal ultrasound examination in Hainan Hospital of Chinese PLA General Hospital were retrospectively analyzed.The diagnostic accuracy of long-axis and short-axis tracking scanning on the internal opening,primary fistula and branch fistula of anal fistula were compared among the patients who completed long-axis and short-axis tracking scanning.Results A total of 75 patients were enrolled,including 33 cases with conventional ultrasonography(CUS)combined with contrast-enhanced ultrasonography(CEUS).In CUS,the diagnostic accuracy of short-axis tracking was higher than that of long-axis tracking,with statistically significant difference(77.33%vs 34.67%,P<0.05).In the diagnostic accuracy of primary fistula and secondary fistula,there was no significant difference between long axis and short axis scanning(primary fistula 86.67%vs 85.33%;branch fistula 44.12%vs 38.24%).In CUS combined with CEUS,the diagnostic accuracy of the internal opening through short axis scanning was higher than that of long axis scanning,with statistically significant difference(90.91%vs 66.67%,P<0.05).In the diagnostic accuracy of primary fistula and branch fistula,there was no significant difference between long axis and short axis scanning(primary fistula 87.88%vs 93.94%;branch fistula 71.43%vs 66.67%).Conclusions Short axis tracking scanning is helpful to improve the accuracy of ultrasonic diagnosis of anal fistula.