三维肛肠超声与X线排粪造影对直肠前突临床诊断价值

3D- anorectal ultrasound versus X-ray defecography in diagnosing rectocele

目的比较三维肛肠超声与X线排粪造影对直肠前突(RC)及其合并症的临床诊断价值。方法对2016年12月至2017年6月收治的42例出口梗阻型便秘(OOC)女性患者分别行三维肛肠超声与X线排粪造影检查,对RC的诊断结果进行比较,比较两种检查方法显示RC情况及程度,统计合并症发生情况。结果经三维肛肠超声检查阳性35例、阴性7例;X线排粪造影检查阳性32例、阴性10例,两组差异无统计学意义(P>0.05)。三维肛肠超声与X线排粪造影图像上诊断均为RC患者共28例,三维肛肠超声与X线排粪造影测量RC深度在轻度、中度、重度RC患者差异均有统计学意义(P<0.05)。两种方法直肠黏膜内套叠、会阴疝和耻骨直肠肌肥厚诊断率,差异无统计学意义(P>0.05)。三维肛肠超声在直肠阴道隔断裂诊断率上高于X线排粪造影,差异有统计学意义(P<0.05)。结论三维肛肠超声与X线排粪造影对RC诊断结果无明显不同。三维肛肠超声诊断RC迅速、可靠、操作简便、费用低、无明显痛苦,图像可行各方位观察。对RC有重要诊断价值。

Objective To compare the value of three-dimensional(3D)-anorectal ultrasound and X-ray defecography in diagnosing rectocele ( RC ). Methods Forty-two female patients with outlet obstruction constipation ( OOC) treated from December 2016 to June 2017 were examined respectively by 3D-anorectal ultrasound and X-ray defecography to compare the diagnostic results of RC, including the status and degree of RC and the incidence of complications. Results There were 35 positive cases and 7 negative cases by 3D- anorectal ultrasound and 32 positive and 10 negative cases by X-ray defecography. There were no significant differences between two groups ( all P > 0. 05 ). Total 28 patients with RC were confirmed by both 3D-anorectal ultrasonography and X-ray defecography. There were significant differences in mild-, moderate- and severe-degree of RC between two inspection methods ( P < 0. 05 ). There were no significant differences in the diagnostic rates of rectal intussusception, perineal hernia and puborectal muscle hypertrophy between two methods ( all P >0. 05 ). The diagnostic rate of rectovaginal septum rupture by 3D- anorectal ultrasonography was statistically higher than that by X-ray defecography (P <0. 05). Conclusion There is no obvious difference in RC diagnosis between 3D-anorectal ultrasound and X-ray defecography. 3D- anorectal ultrasound has more advantages in rapid, reliable, easy to operate, low cost and without obvious pain in diagnosis of RC, and its image can be observed in multiple directions. It has important diagnostic value for RC.