经直肠超声与高频超声联合诊断复杂性肛痰的临床价值分析

Value of combining trans-rectal ultrasound and high-frequency ultrasound in diagnosing complex anal fistula

目的探讨经直肠超声与高频超声联合诊断复杂性肛瘘的临床价值。方法回顾性分析2015年10月至2017年10月本院收治的90例复杂性肛瘘患者临床资料,所有患者术前均接受经直肠超声和高频超声检查,记录经直肠超声和高频超声的影像特点,分析联合检查诊断的灵敏度、特异度、误诊率及漏诊率。结果复杂性肛瘘经直肠超声和高频超声可见条索状低回声和瘘管走行不规则。超声联合检查检出复杂性肛瘘90例,检出率100%,联合超声诊断结果与手术病理结果一致性满意(Kappa值=0.837,P=0.000),诊断复杂性肛瘘分型的准确率为92.22%,特异度均高于90%。结论经直肠超声与高频超声联合诊断复杂性肛瘘结果对临床治疗有较高的参考价值。

Objective To investigate the value of combining traMs-rectal ultrasound and high-frequency ultrasound in diagnosing complex anal fistula. Methods We performed a retrospective analysis of clinical data from 90 patients with complex anal fistula treated in our hospital from October 2015 to October 2017. All patients received before operation traMs-rectal ultrasound and high- frequency ultrasound. Features from traMs-rectal ultrasound and high-frequency ultrasound were recorded. Sensitivity, specificity, false positive rate, false negative rate of combining traMs-rectal ultrasound and high-frequency ultrasound for diagnosis were analyzed. Results Features from traMs-rectal ultrasound and high-frequency ultrasound for complex anal fistula were hypoechoic bands and irregular shape of fistula. All 90 patients were diagnosed with complex anal fistula by the combination of two ultrasound modalities with 100% detection rate. Agreement between combination of two ultrasound modalities and pathology findings was satisfactory （Kappa = 0.837, P = 0.000）. Accuracy of diagnosis was 92.22%, and specificity was all higher than 90%. Conclusion The value of combining traMs-rectal ultrasound and high-frequency ultrasound in diagnosing complex anal fistula is high.