Diagnostic value of trans-fistula contrast-enhanced ultrasound in anal fistula

doi:10.3877/cma.j.issn.1672-6448.2018.11.011

Abstract

Abstract:

Objective

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

Methods

An analysis was performed of 98 patients with anal fistula who underwent conventional ultrasound and trans-fistula CEUS from February 2016 to December 2017. We recorded the following parameters: fistulous trend and its positional relation with levator ani muscle and sphincter (Parks classification); the number of fistulous branches; the number of fistulas, the position of fistula, and the distance between fistulous internal opening and anal edge. Then, we compared these parameters with surgical diagnostic results.

Results

The accuracy of Parks classification performed by trans-fistula CEUS was significantly higher than that of conventional ultrasound (90.82% vs 80.61%, χ²=4.167, P=0.041). The accuracy of trans-fistula CEUS in the diagnosis of branch fistula was lower than that of conventional ultrasonography (81.08% vs 86.49%), but there was no significant difference (χ²=0.400, P>0.05). The accuracy of trans-fistula CEUS was significantly higher than that of conventional ultrasonography (92.68% vs 78.05%, χ²=10.543, P=0.001).

Conclusion

Trans-fistula CEUS has a high accuracy in the Parks classification and in the judgment of the internal orifice of anal fistula. It can make up for the deficiency of conventional ultrasonography and provide a basis for clinical treatment decision-making.

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

Hua Yin, Jingjing Hu, Xiuzhi Wei, Haidong Ruan, Jianpei Zhao, Saijun Chen. Diagnostic value of trans-fistula contrast-enhanced ultrasound in anal fistula[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(11): 844-849.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.11.011

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I11/844

Figures/Tables 4

References 20

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手术诊断结果	常规超声诊断结果				超声造影诊断结果
手术诊断结果	Is	Ts	Ss	Es	Is	Ts	Ss	Es
Is（n=53）	46	5	1	1	50	2	0	1
Ts（n=35）	3	29	2	1	1	32	1	1
Ss（n=4）	0	1	1	2	0	0	2	2
Es（n=6）	0	1	2	3	0	0	1	5
合计（n=98）	49	36	6	7	51	34	4	9

手术诊断结果	常规超声诊断结果				超声造影诊断结果
手术诊断结果	Is	Ts	Ss	Es	Is	Ts	Ss	Es
Is（n=53）	46	5	1	1	50	2	0	1
Ts（n=35）	3	29	2	1	1	32	1	1
Ss（n=4）	0	1	1	2	0	0	2	2
Es（n=6）	0	1	2	3	0	0	1	5
合计（n=98）	49	36	6	7	51	34	4	9

分类		准确性	敏感度	特异度	阳性预测值	阴性预测值
Is		?	?	?	?	?
?	常规超声	89.80（88/98）	86.79（46/53）	93.33（42/45）	93.88（46/49）	85.71（42/49）
?	超声造影	95.92（94/98）	94.33（50/53）	97.78（44/45）	98.04（50/51）	93.62（44/47）
Ts		?	?	?	?	?
?	常规超声	86.73（85/98）	82.86（29/35）	88.89（56/63）	62.50（29/36）	90.32（56/62）
?	超声造影	94.90（93/98）	91.43（32/35）	96.83（61/63）	73.33（32/34）	95.31（61/64）
Ss		?	?	?	?	?
?	常规超声	91.84（90/98）	25.00（1/4）	94.68（89/94）	16.67（1/6）	96.74（89/92）
?	超声造影	95.92（94/98）	50.00（2/4）	97.87（92/94）	50.00（2/4）	97.87（92/94）
Es		?	?	?	?	?
?	常规超声	92.86（91/98）	50.00（3/6）	95.65（88/92）	42.86（3/7）	96.70（88/91）
?	超声造影	94.90（93/98）	83.33（5/6）	95.65（88/92）	55.56（5/9）	98.88（88/89）

分类		准确性	敏感度	特异度	阳性预测值	阴性预测值
Is		?	?	?	?	?
?	常规超声	89.80（88/98）	86.79（46/53）	93.33（42/45）	93.88（46/49）	85.71（42/49）
?	超声造影	95.92（94/98）	94.33（50/53）	97.78（44/45）	98.04（50/51）	93.62（44/47）
Ts		?	?	?	?	?
?	常规超声	86.73（85/98）	82.86（29/35）	88.89（56/63）	62.50（29/36）	90.32（56/62）
?	超声造影	94.90（93/98）	91.43（32/35）	96.83（61/63）	73.33（32/34）	95.31（61/64）
Ss		?	?	?	?	?
?	常规超声	91.84（90/98）	25.00（1/4）	94.68（89/94）	16.67（1/6）	96.74（89/92）
?	超声造影	95.92（94/98）	50.00（2/4）	97.87（92/94）	50.00（2/4）	97.87（92/94）
Es		?	?	?	?	?
?	常规超声	92.86（91/98）	50.00（3/6）	95.65（88/92）	42.86（3/7）	96.70（88/91）
?	超声造影	94.90（93/98）	83.33（5/6）	95.65（88/92）	55.56（5/9）	98.88（88/89）

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