彩色多普勒超声在肛周脓肿及肛瘘中的应用价值

Application of Color Doppler Ultrasound in Perianal Abscess and Anal Fistula

目的探讨彩色多普勒超声浅表高频探头在肛周脓肿和肛瘘中的应用价值。方法回顾性分析我院2015年1月至2016年8月经手术病理证实的、应用浅表高频探头诊断的60例肛周脓肿及肛瘘病例资料。结果 60例中肛周脓肿58例,肛瘘2例。脓肿形成早期声像图表现为肛周低回声区,境界不清,回声部均匀,CDFI显示内部可见点状、条状彩色血流信号,周边较多血流;脓肿形成期表现为肛周大小不等、形态不规则低回声、无回声或混和回声区,内可见液性暗区回声或充满细小光点回声,周边境界模糊、伴血流信号,探头挤压时,有波动感,大小有变化,内部光点回声可移动,后壁回声增强;瘘管表现为细长条管状低回声带,部分可见强回声气体影,可见内外口。本组超声术前定位与手术病理结果一致。结论彩超浅表高频探头可较好显示肛周脓肿及肛瘘的影像学特征,值得应用。

Objective To investigate the application value of color doppler ultrasound with superficial high-frequency probe in perianal abscess and anal fistula. Methods From January 2015 to August 2016,in our hospital, the data of 60 patients with perianal abscess and anal fistula diagnosed by color doppler ultrasound with superficial high-frequency probe confirmed pathologically were retrospectively analyzed. Results Of all the 60 cases, 58 cases were perianal abscess, 2 cases were anal fistula. On the sonographic imagings, early abscess formation showed perianal hypoechoic zone,with obscure boundary and uniform echo, CDFI showed scattered, strip color flow signal, more blood flow around; abscess formation period showed irregular low echo, no echo or mixed echo area, ranging from sizes and shapes, liquid dark area or full of tiny points of light echo could be seen, peripheral level fuzzy, with blood flow signals. When probe extruded,the lesion was filled with a sense of volatility and the size changed, internal light echo mobiled, back wall echo enhancement.Fistula showed a slender tubular hypoechoic zone, partially with echogenic gas signal, the entry and outlet could be seen. Preoperative localization was consistent with the results of surgery and pathology in this group. Conclusion Color doppler ultrasonography with superficial probe can betterly display the imaging features of perianal abscess and anal fistula, so it is worth of application.