高频超声评估女性肛门括约肌完整性的临床研究

Clinical study of high-frequency ultrasound in evaluating the integrity of female anal sphincter

目的探讨高频超声在评估女性肛门括约肌完整性中的价值。方法选取在我院行盆底超声检查的110例女性受检者,应用高频超声分别从横断面及矢状面对其肛门括约肌行连续性扫查;由两名不同经验的超声医师(A、B)在双盲情况下独立对肛门括约肌影像进行完整性评价,记录肛门括约肌损伤情况并行一致性检验。结果高频超声可从横断面及矢状面清晰显示所有受检者各水平肛管特征性的解剖结构。当肛门括约肌存在损伤时,可以清楚观察到肛门括约肌回声连续性中断等异常的超声表现。在110例受检者中,超声医师A检出10例肛门括约肌损伤,其中2例为肛门内括约肌损伤,6例为肛门外括约肌损伤,2例为肛门内、外括约肌损伤;超声医师B检出9例肛门括约肌损伤,其中2例为肛门内括约肌损伤,4例为肛门外括约肌损伤,3例为肛门内、外括约肌损伤。两名不同经验的超声医师应用高频超声评估肛门括约肌完整性的一致性强(Kappa=0.888,P<0.05)。结论应用高频超声可对女性肛门括约肌各水平清晰显像,为评估肛门括约肌完整性提供了一种新的影像学方法。

ObjectiveTo explore the value of high-frequency ultrasound in evaluating the integrity of female analsphincter.MethodsOne hundred and ten female subjects who underwent pelvic floor ultrasonography in our hospital wereselected.High-frequency ultrasound was used to scan the anal sphincter continuously from the cross-section and sagittal plane.Two sonographers with different experiences(ultrasound doctor A and B)independently evaluated the integrity of the analsphincter images under mutual blindness,the damage of the anal sphincter was recorded,and the consistency was analyzed.ResultsIn 110 subjects,high-frequency ultrasound can clearly showed the characteristic anatomical structure of each level ofthe anal canal from the cross-sectional and sagittal planes. When the anal sphincter damaged,the ultrasonic abnormalmanifestations showed the echo of the anal sphincter was interrupted continuously.Among the 110 subjects,the ultrasound doctorA detected 10 cases of anal sphincter injury,including 2 cases of internal anal sphincter injury,6 cases of external anal sphincterinjury,and 2 cases of internal anal sphincter combined with external sphincter injury.Ultrasound doctor B detected 9 cases ofanal sphincter injury,including 2 cases of internal anal sphincter injury,4 cases of external anal sphincter injury,and 3 cases ofinternal anal sphincter combined with external sphincter injury.Sonographers with different experiences had strong consistency inevaluating the integrity of anal sphincter by high-frequency ultrasound(Kappa=0.888,P<0.05).ConclusionHigh-frequencyultrasound can realize the evaluation of the integrity of female anal sphincter through precise imaging of each level of the analcanal,and provide a new imaging method for the assessment of the anal sphincter.