Preoperative assessment of fistula-in-ano using SonoVue enhancement during three-dimensional transperineal ultrasound.

IF 3.8 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Gastroenterology Report Pub Date : 2024-02-27 eCollection Date: 2024-01-01 DOI:10.1093/gastro/goae002
Jun Yang, Qing Li, Hua Li, Heng Zhang, Donglin Ren, Zhiyi Zhang, Dan Su, Haihua Qian
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引用次数: 0

Abstract

Background: Accurate preoperative evaluation of fistula-in-ano can guide the choice of surgical procedure and may improve healing rates. This prospective study aimed to evaluate the accuracy of conventional 3D transperineal ultrasound (3D-TPUS) compared with SonoVue (SVE)-enhanced 3D-TPUS for the detection and classification of anal fistula.

Methods: In this prospective study, 3D-TPUS reconstructions were performed before and after SVE enhancement in 60 patients with fistula-in-ano who intended to undergo surgery at the Department of Anorectal Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University (P. R. China) between January 2021 and October 2021. Accuracies of anal fistula classification, complexity classification, detection of anal fistula branches, and detection of internal opening between 3D-TPUS and SVE 3D-TPUS were compared based on a reference standard-intraoperative findings.

Results: This study enrolled 60 patients (mean age, 37.1 ± 11.4 years; mean follow-up, 9 ± 3 months). Intraoperative findings showed that the fistula type was intersphincteric in 23 patients (38.3%), trans-sphincteric in 35 (58.3%; 12 high and 23 low), and suprasphincteric in 2 (3.3%). Moreover, 68 internal openings were found. Compared with the accuracy of 3D-TPUS, that of SVE 3D-TPUS was similar in fistula classification [95.0% (57/60) vs 96.7% (58/60), P =0.392], but significantly higher in internal opening evaluation [80.9% (55/68) vs 97.1% (66/68), P =0.001], complexity classification [85.0% (51/60) vs 98.3% (59/60), P =0.018], and detection of fistula branches [70.4% (19/27) vs 92.6% (25/27), P =0.031].

Conclusions: SVE 3D-TPUS may be a useful examination for patients with perianal fistulae because of its high accuracy and consistency with intraoperative findings, especially in complex fistula-in-ano and difficult cases.

在三维经会阴超声中使用 SonoVue 增强技术对肛瘘进行术前评估。
背景:对肛瘘进行准确的术前评估可指导手术方法的选择,并可提高治愈率。这项前瞻性研究旨在评估传统三维经会阴超声(3D-TPUS)与SonoVue(SVE)增强型3D-TPUS在检测和分类肛瘘方面的准确性:在这项前瞻性研究中,2021年1月至2021年10月期间,山东大学齐鲁医学院齐鲁医院肛肠外科对60名拟接受手术的肛瘘患者在SVE增强前后进行了3D-TPUS重建。根据参考标准--术中发现,比较了3D-TPUS和SVE 3D-TPUS在肛瘘分类、复杂性分类、肛瘘分支检测和内口检测方面的准确性:该研究共纳入 60 名患者(平均年龄为 37.1 ± 11.4 岁;平均随访时间为 9 ± 3 个月)。术中结果显示,23 名患者(38.3%)的瘘管类型为括约肌间型,35 名患者(58.3%;12 名高位,23 名低位)的瘘管类型为经括约肌型,2 名患者(3.3%)的瘘管类型为括约肌上型。此外,还发现了 68 个内部开口。与 3D-TPUS 的准确性相比,SVE 3D-TPUS 在瘘管分类方面的准确性相似 [95.0% (57/60) vs 96.7% (58/60),P = 0.392],但在内部开口评估方面的准确性明显更高 [80.9% (55/68) vs 97.1% (66/68),P = 0.001]、复杂性分类[85.0% (51/60) vs 98.3% (59/60),P = 0.018]和瘘管分支检测[70.4% (19/27) vs 92.6% (25/27),P = 0.031]:SVE 3D-TPUS 可作为肛周瘘患者的有效检查手段,因为其准确性高且与术中发现一致,尤其适用于复杂的肛周瘘和疑难病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Gastroenterology Report
Gastroenterology Report Medicine-Gastroenterology
CiteScore
4.60
自引率
2.80%
发文量
63
审稿时长
8 weeks
期刊介绍: Gastroenterology Report is an international fully open access (OA) online only journal, covering all areas related to gastrointestinal sciences, including studies of the alimentary tract, liver, biliary, pancreas, enteral nutrition and related fields. The journal aims to publish high quality research articles on both basic and clinical gastroenterology, authoritative reviews that bring together new advances in the field, as well as commentaries and highlight pieces that provide expert analysis of topical issues.
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