Application value of dual contrast-enhanced ultrasound in diagnosis of anal fistula

doi:10.3877/cma.j.issn.1672-6448.2020.10.005

Abstract

Abstract:

Objective

To assess the clinical value of dual contrast-enhanced ultrasound (DCEUS) in diagnosing anal fistula.

Methods

Seventy-nine patients with anal fistula who received ultrasonography and DCEUS examination at the Department of Anorectal Surgery, Hwa Mei Hospital, University of Chinese Academy of Sciences from January 2018 to June 2019 were retrospectively selected. We recorded below parameters: the number and position of fistulous external openings and the distance between fistulous external opening and anal edge; fistulous track and its positional relation with levator ani muscle and sphincter (Parks classification); the number and position of fistulous internal openings and the distance between fistulous internal opening and anal edge; and the track and number of fistulous branches. Then we compared these parameters with surgical diagnosis.

Results

The accuracy rates of DCEUS and ultrasonography in diagnosing the Parks classification (92.41% vs 79.75%, χ²=5.247, P=0.022), internal openings (92.79% vs 76.58%, χ²=11.202, P=0.001), and branches (85.71% vs 62.86%, χ²=4.718, P=0.030) differed signficantly.

Conclusion

DCEUS examination is increasingly playing a significant role in ultrasound diagnosis. It has high accuracy in the diagnosis of the Parks classification, the internal openings, and the branches of anal fistulas.

Key words: Ultrasonography, Contrast-enhanced ultrasound, Anal fistula

Hua Yin, Jingjing Hu, Changrui Sheng, Fangfang Hong, Shanshan Yu. Application value of dual contrast-enhanced ultrasound in diagnosis of anal fistula[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(10): 958-964.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2020.10.005

https://chaosheng.cma-cmc.com.cn/EN/Y2020/V17/I10/958

Figures/Tables 7

References 20

1	PaZubaidi AM. Anal fistula past and present [J]. Saudi Med, 2014, 35(9): 937-944.
2	章蓓. 肛管直肠及其周围疾病超声诊断图谱 [M]. 上海: 上海科学技术出版社, 2016.
3	Vogel JD, Johnson EK, Morris AM, et al. Clinical practice guideline for the management of anorectal abscess, fistula-inano,and rectovaginal fistula [J]. Dis Colon Rectum, 2016, 59(12): 1117-1133.
4	段宗文，王金锐. 临床超声医学 [M]. 北京: 科学技术文献出版社, 2017.
5	Sidhu PS, Cantisani V, Dietrich CF, et al. The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: update 2017 (long version) [J]. Ultraschall Med, 2018, 39(2): e2-e44.
6	范小辉，谢灵. 经直肠腔内超声联合过氧化氢造影诊断肛瘘的应用价值 [J]. 中国实用医学, 2015, 72(6): 111-112.
7	吴盛正，吕发勤，闻巍, 等. 经肛瘘超声造影在复杂性肛瘘术前诊断中的应用价值 [J/CD]. 中华医学超声杂志(电子版), 2018, 15(7): 511-514.
8	Cathy L, Christina M, Alexandra M, et al. Grayscale and Doppler Ultrasound, Contrast Enhancement, and Elastography in Crohn Disease [J]. J Ultrasound Med, 2019, 38(9): 271-288.
9	吴长君，吴国柱. 肛瘘的超声诊断进展 [J/CD]. 中华医学超声杂志(电子版), 2012, 9(4): 48-51.
10	陈红燕，詹维伟，王栋华, 等. 三维超声在肛瘘内口定位中的应用 [J]. 中国医学影像学杂志, 2016, 24(2): 126-129.
11	Ozkavukcu E, Halioglu N, Erden A. Frequencies of perianal fistula types using two classification systems [J]. Jpn J Radiol, 2011, 29(5): 293-300.
12	李巧华. 肛瘘术后复发的临床因素分析 [J]. 中国肛肠病杂志, 2017, 37(3): 21-23.
13	Ortega AE, Gesek A, Linnebur M, et al. Selected Techniques of Anal Fistula Surgery from Antiquity Through the Early 20th Century Illustrated [J]. Dis Colon Rectum, 2017, 60(6): 636-646.
14	Steele SR, Kumar R, Feingold DL, et al. Practice parameters for the management of perianal abscess and fistula-in-ano [J]. Dis Colon Rectum, 2011, 54(12): 1465-1474.
15	葛士骝，杜联芳，马静, 等. 经直肠联合体表超声在肛周疾病的诊断价值 [J]. 中国超声医学杂志, 2016, 32(10): 937.
16	叶丽娥，任伟涛，陈小燕, 等. 双平面腔内超声联合新型微泡显影剂超声造影诊断肛瘘内口的价值 [J]. 中国中西医结合影像学杂志, 2018, 16(6): 649-650.
17	Sun Y, Cui L, Liu J, et al. Utility of 360° real-time endoanal sonography for evaluation of perianal fistulas [J]. J Ultrasound Med, 2017, 37(1): 93-98.
18	Luglio G, Giglio MC, Rispo A, et al. Diagnostic Accuracy of 3-Dimensional Endoanal Ultrasound in Identifying Perianal Crohn's Fistulas [J]. Dis Colon Rectum, 2018, 61(8): 931-937.
19	殷骅，胡晶晶，魏秀芝, 等. 经瘘管超声造影在肛瘘诊断中的应用 [J/CD]. 中华医学超声杂志(电子版), 2018, 15(11): 844-849.
20	吴宾玉，许佑君. 声诺维 [J]. 中国药物化学杂志, 2015, 25(2): 161.

方法	Parks分类[例（%），n=79]	肛瘘内口[个（%），n=111]	分支瘘管[条（%），n=35]
常规二维超声	63/79（79.75）	85/111（76.58）	22/35（62.86）
双重超声造影	73/79（92.41）	103/111（92.79）	30/35（85.71）
χ²值	5.247	11.202	4.718
P值	0.022	0.001	0.030

方法	Parks分类[例（%），n=79]	肛瘘内口[个（%），n=111]	分支瘘管[条（%），n=35]
常规二维超声	63/79（79.75）	85/111（76.58）	22/35（62.86）
双重超声造影	73/79（92.41）	103/111（92.79）	30/35（85.71）
χ²值	5.247	11.202	4.718
P值	0.022	0.001	0.030

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