经体表超声联合瘘管超声造影在复杂性肛瘘术前评估中的应用价值OA

Objective:To explore the application value of transcutaneous ultrasound combined with fistula contrast-enhanced ultrasound(CEUS)in the preoperative evaluation of complex anal fistulas.Methods:A prospective controlled study design was employed.A total of 80 patients with complex anal fistulas confirmed by postoperative pathology were selected.Preoperative ultrasound examinations were performed.Among them,40 cases underwent conventional transcutaneous ultrasound combined with endocavitary ultrasound examination(conventional ultrasound group),and 40 cases underwent transcutaneous ultrasound combined with fistula CEUS(CEUS group).The main fistula,branch fistula,location and number of internal openings,abscess cavity,and Parks classification were recorded.The surgical results were used as the reference standard to analyze the diagnosis results of the two ultrasound methods.Results:There were no statistically significant differences between the two groups in the diagnostic accordance rate of internal openings,main fistulas,or abscess cavities(all P>0.05).The diagnostic accordance rate for branch fistulas in the CEUS group and the conventional ultrasound group were 93.5%(86/92)and 83.5%(76/91),respectively,with a statistically significant difference(P<0.05),while the diagnostic accordance rate for Parks classification of complex anal fistulas were 87.5%(35/40)and 92.5%(37/40),respectively,with no statistically significant difference(P>0.05).Conclusions:Transcutaneous ultrasound combined with fistula CEUS can clearly display the internal opening,main fistula,branch fistula,and abscess cavity structures of complex anal fistulas and achieve precise classification.It shows high diagnostic accuracy for branch fistulas compared with conventional ultrasound.For complex anal fistulas that cannot undergo endocavitary examination,transcutaneous ultrasound combined with fistula CEUS can be performed to provide more evidence for clinical treatment.