• 四川大學（成都，610041） 1 華西醫(yī)院國家藥物試驗臨床機構(gòu)，2 公共衛(wèi)生學院，3 華西醫(yī)院超聲科;

【摘要】　 肛瘺及肛周膿腫是肛腸外科較常見疾病，其手術(shù)治療對醫(yī)生迄今仍是一個挑戰(zhàn)，因為醫(yī)生既希望手術(shù)根治疾病，防止復發(fā)，又要避免手術(shù)損傷引起大便失禁，因此術(shù)前準確定位至關(guān)重要?，F(xiàn)代超聲技術(shù)能準確定位肛瘺的內(nèi)口、主管、支管、膿腔，能較為準確地顯示瘺管與周圍組織的關(guān)系，為醫(yī)生制定個體化的手術(shù)方案提供幫助?，F(xiàn)根據(jù)國內(nèi)外發(fā)表的相關(guān)文獻綜述超聲檢查對肛瘺及肛周膿腫的診斷，以期對臨床工作起到一定的指導作用。

引用本文： 李梅,馮萍,牟桔紅,袁佳英,李永忠. 肛瘺及肛周膿腫的超聲診斷現(xiàn)狀. 華西醫(yī)學, 2011, 26(11): 1744-1746. doi: 復制

1. 　Kim Y, Park YJ. Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H2O2 enhancement[J]. World J Gastroenterol, 2009, 15(38): 4810-4815.
2. 　蔡燕娥, 金宏江, 范廣民, 等. 經(jīng)體表高頻超聲在肛周膿腫和肛瘺診斷中的應用[J]. 中國醫(yī)學計算機成像雜志, 2009(15): 558-560.
3. 　張國平, 駢林萍, 李超. 經(jīng)直腸超聲和高頻超聲聯(lián)合應用診斷直腸周圍膿腫合并肛瘺的價值[J]. 醫(yī)藥論壇雜志, 2010, (14): 158-159.
4. 　張曉蓉, 陳真, 彭勃. 高頻線陣及經(jīng)直腸腔內(nèi)超聲對肛瘺及肛周膿腫的診斷價值[J]. 中國醫(yī)學影像技術(shù), 2008, 24(7): 1086-1089.
5. 　銀浩強, 彭欣, 肖滬生, 等. 經(jīng)直腸超聲診斷肛瘺的價值[J]. 上海醫(yī)學影像, 2007, 16(2): 149-153.
6. 　Toyonaga T, Tanaka Y, Song JF, et al. Comparison of accuracy of physical examination and endoanal ultrasonography for preoperative assessment in patients with acute and chronic anal fistula[J]. Techniq Coloproctol, 2008, 12(3): 217-223.
7. 　Pomerri F, Dodi G, Pintacuda G. Anal endosonography and fistulography for fistula-in-ano[J]. Radiologia Medica, 2010, 115(5): 771-783.
8. 　Buchanan GN, Halligan S, Bartram CI, et al. Clinical examination, endosonography, and MR imaging in preoperative assessment of fistula in ano: comparison with outcome-based reference standard[J]. Radiology, 2004, 233(3): 674-681.
9. 　Kleinubing H Jr, Jannini JF, Campos AC, et al. The role of transperineal ultrasonography in the assessment of the internal opening of cryptogenic anal fistula[J]. Techniq Coloproctol, 2007, 11(4): 327-331.
10. 　Domkundwar SV, Shinagare AB. Role of transcutaneous perianal ultrasonography in evaluation of fistulas in ano[J]. Journal of Ultrasound Med, 2007, 26(1): 29-36.
11. 　Weisman N, Abbas MA. Prognostic value of endoanal ultrasound for fistula-in-ano: a retrospective analysis[J]. Dis Colon Rectum, 2008, 51(7): 1089-1092.
12. 　Sudol-Szopinska I, Kolodziejczak M, Szopinski TR. The accuracy of a postprocessing technique-volume render mode-in three-dimensional endoanal ultrasonography of anal abscesses and fistulas[J]. Dis Colon Rectum, 2011, 54(2): 238-244.
13. 　Buchanan GN, Bartram CI, Williams AB, et al. Value of hydrogen peroxide enhancement of three-dimensional endoanal ultrasound in fistula-in-ano[J]. Dis Colon Rectum, 2005, 48(1): 141-147.
14. 　West RL, Dwarkasing S, Felt-Bersma RJ, et al. Hydrogen peroxide-enhanced three-dimensional endoanal ultrasonography and endoanal magnetic resonance imaging in evaluating perianal fistulas: agreement and patient preference[J]. Eur J Gastroenterol Hepatol, 2004, 16(12): 1319-1324.
15. 　徐道明, 李升明. 經(jīng)肛管腔內(nèi)超聲過氧化氫增強造影診斷肛瘺的價值[J]. 中國超聲醫(yī)學雜志, 2001, 17(9): 705-707.
16. 　Sudol-Szopinska I, Szczepkowski M, Panorska AK, et al. Comparison of contrast-enhanced with non-contrast endosonography in the diagnostics of anal fistulas[J]. Eur Radiol, 2004, 14(12): 2236-2241.
17. 　Pascual Miguelanez I, Garcia-Olmo D, Martinez-Puente MC, et al. Is routine endoanal ultrasound useful in anal fistulas?[J]. Revista Espanola de Enfermedades Digestivas, 2005, 97(5): 323-327.
18. 　Zbar AP, Oyetunji RO, Gill R. Transperineal versus hydrogen peroxide-enhanced endoanal ultrasonography in never operated and recurrent cryptogenic fistula-in-ano: a pilot study[J]. Techniq Coloproctol, 2006, 10(4): 297-302.
  1. 1. 　Kim Y, Park YJ. Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H2O2 enhancement[J]. World J Gastroenterol, 2009, 15(38): 4810-4815.
  2. 2. 　蔡燕娥, 金宏江, 范廣民, 等. 經(jīng)體表高頻超聲在肛周膿腫和肛瘺診斷中的應用[J]. 中國醫(yī)學計算機成像雜志, 2009(15): 558-560.
  3. 3. 　張國平, 駢林萍, 李超. 經(jīng)直腸超聲和高頻超聲聯(lián)合應用診斷直腸周圍膿腫合并肛瘺的價值[J]. 醫(yī)藥論壇雜志, 2010, (14): 158-159.
  4. 4. 　張曉蓉, 陳真, 彭勃. 高頻線陣及經(jīng)直腸腔內(nèi)超聲對肛瘺及肛周膿腫的診斷價值[J]. 中國醫(yī)學影像技術(shù), 2008, 24(7): 1086-1089.
  5. 5. 　銀浩強, 彭欣, 肖滬生, 等. 經(jīng)直腸超聲診斷肛瘺的價值[J]. 上海醫(yī)學影像, 2007, 16(2): 149-153.
  6. 6. 　Toyonaga T, Tanaka Y, Song JF, et al. Comparison of accuracy of physical examination and endoanal ultrasonography for preoperative assessment in patients with acute and chronic anal fistula[J]. Techniq Coloproctol, 2008, 12(3): 217-223.
  7. 7. 　Pomerri F, Dodi G, Pintacuda G. Anal endosonography and fistulography for fistula-in-ano[J]. Radiologia Medica, 2010, 115(5): 771-783.
  8. 8. 　Buchanan GN, Halligan S, Bartram CI, et al. Clinical examination, endosonography, and MR imaging in preoperative assessment of fistula in ano: comparison with outcome-based reference standard[J]. Radiology, 2004, 233(3): 674-681.
  9. 9. 　Kleinubing H Jr, Jannini JF, Campos AC, et al. The role of transperineal ultrasonography in the assessment of the internal opening of cryptogenic anal fistula[J]. Techniq Coloproctol, 2007, 11(4): 327-331.
  10. 10. 　Domkundwar SV, Shinagare AB. Role of transcutaneous perianal ultrasonography in evaluation of fistulas in ano[J]. Journal of Ultrasound Med, 2007, 26(1): 29-36.
  11. 11. 　Weisman N, Abbas MA. Prognostic value of endoanal ultrasound for fistula-in-ano: a retrospective analysis[J]. Dis Colon Rectum, 2008, 51(7): 1089-1092.
  12. 12. 　Sudol-Szopinska I, Kolodziejczak M, Szopinski TR. The accuracy of a postprocessing technique-volume render mode-in three-dimensional endoanal ultrasonography of anal abscesses and fistulas[J]. Dis Colon Rectum, 2011, 54(2): 238-244.
  13. 13. 　Buchanan GN, Bartram CI, Williams AB, et al. Value of hydrogen peroxide enhancement of three-dimensional endoanal ultrasound in fistula-in-ano[J]. Dis Colon Rectum, 2005, 48(1): 141-147.
  14. 14. 　West RL, Dwarkasing S, Felt-Bersma RJ, et al. Hydrogen peroxide-enhanced three-dimensional endoanal ultrasonography and endoanal magnetic resonance imaging in evaluating perianal fistulas: agreement and patient preference[J]. Eur J Gastroenterol Hepatol, 2004, 16(12): 1319-1324.
  15. 15. 　徐道明, 李升明. 經(jīng)肛管腔內(nèi)超聲過氧化氫增強造影診斷肛瘺的價值[J]. 中國超聲醫(yī)學雜志, 2001, 17(9): 705-707.
  16. 16. 　Sudol-Szopinska I, Szczepkowski M, Panorska AK, et al. Comparison of contrast-enhanced with non-contrast endosonography in the diagnostics of anal fistulas[J]. Eur Radiol, 2004, 14(12): 2236-2241.
  17. 17. 　Pascual Miguelanez I, Garcia-Olmo D, Martinez-Puente MC, et al. Is routine endoanal ultrasound useful in anal fistulas?[J]. Revista Espanola de Enfermedades Digestivas, 2005, 97(5): 323-327.
  18. 18. 　Zbar AP, Oyetunji RO, Gill R. Transperineal versus hydrogen peroxide-enhanced endoanal ultrasonography in never operated and recurrent cryptogenic fistula-in-ano: a pilot study[J]. Techniq Coloproctol, 2006, 10(4): 297-302.