经腔道超声造影用于诊断瘘的价值

doi:10.3877/cma.j.issn.2095-3232.2013.05.008

中华肝脏外科手术学电子杂志 ›› 2013, Vol. 02 ›› Issue (05) : 306 -309. doi: 10.3877/cma.j.issn.2095-3232.2013.05.008

所属专题：文献；

临床研究

经腔道超声造影用于诊断瘘的价值

许尔蛟¹, 郭欢仪¹, 任洁¹, 张曼¹, 苏中振¹, 郑荣琴¹^,^†(

)

^1. 510630　广州，中山大学附属第三医院超声科

收稿日期:2013-06-04 出版日期:2013-10-10
通信作者: 郑荣琴
基金资助:
广东省医学科研基金(B2013137); 广东省科技计划项目(2009B060700026)

Value of intracavitary contrast-enhanced ultrasound in the diagnosis of fistulas

Er-jiao XU¹, Huan-yi GUO¹, Jie REN¹, Man ZHANG¹, Zhong-zhen SU¹, Rong-qin ZHENG¹^,^†()

^1. Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China

Received:2013-06-04 Published:2013-10-10
Corresponding author: Rong-qin ZHENG
About author:
Corresponding author: ZHENG Rong-qin, Email: zhengrongqin@hotmail.com

全文 ( ) 下载PDF ( ) 导出引用

目的

探讨经腔道超声造影（IC-CEUS）用于诊断瘘的价值。

方法

回顾性分析2009年6月至2012年7月在中山大学附属第三医院超声科先后接受常规超声检查（CUS）、IC-CEUS，经X线瘘管造影或手术证实的20例瘘患者临床资料。所有患者均签署知情同意书，符合医学伦理学规定。其中男14例，女6例；年龄17~77岁，中位年龄56岁。分别计算CUS和IC-CEUS对瘘的诊断符合率。两种方法的诊断符合率比较采用χ²检验。

结果

20例患者中，CUS确诊瘘5例，但未能明确定位瘘管，诊断符合率为25%（5/20）。IC-CEUS确诊瘘18例，均能明确定位瘘管，诊断符合率为90%（18/20）。IC-CEUS对瘘的诊断符合率明显高于CUS，差异有统计学意义（χ²=17.289，P<0.05）。

结论

相对于CUS检查，IC-CEUS对瘘有较高的检出能力，有可能成为诊断瘘的重要影像学手段之一。

关键词: 超声检查，介入性, 超声检查, 瘘, 诊断, 放射学，介入性

Objective

To investigate the value of intracavitary contrast-enhanced ultrasound (IC-CEUS) in the diagnosis of fistulas.

Methods

Clinical data of 20 patients in Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University from June 2009 to July 2012 were enrolled in the study for retrospective analysis. The patients underwent examinations of conventional ultrasound (CUS) and IC-CEUS, and were confirmed with fistulas by X-ray fistulogram or operation. The informed consents of all patients were obtained and the ethical committee approval was received. There were 14 males and 6 females with age ranging from 17 to 77 years old and median age of 56 years old. The diagnostic coincidence rates of fistulas by CUS and IC-CEUS were calculated respectively. And the difference between two methods was compared by Chi-square test.

Results

Five fistulas were detected by CUS with the diagnostic coincidence rates of 25% (5/20), while the fistulas could not be located exactly. Eighteen fistulas were detected by IC-CEUS with the diagnostic coincidence rate of 90% (18/20) and all the fistulas could be located exactly. The diagnostic coincidence rate of IC-CEUS was evidently higher than that of CUS. There was significant difference between two methods(χ²=17.289, P<0.05).

Conclusions

IC-CEUS has higher detective ability for fistulas than CUS and it could be one of the important imaging means in the diagnosis of fistulas.

Key words: Ultrasonography, interventional, Ultrasonography, Fistula, Diagnosis, Radiology, interventional

表1 CUS和IC-CEUS对瘘的诊断情况

诊断方法	例数	确诊例数	诊断符合率(%)
CUS	20	5	25
IC-CUS	20	18	90
χ²值	?	?	17.289
P值	?	?	<0.05

表1 CUS和IC-CEUS对瘘的诊断情况

诊断方法	例数	确诊例数	诊断符合率(%)
CUS	20	5	25
IC-CUS	20	18	90
χ²值	?	?	17.289
P值	?	?	<0.05

[1]	Pickhardt PJ,Bhalla S,Balfe DM. Acquired gastrointestinal fistulas: classification, etiologies, and imaging evaluation. Radiology, 2002, 224(1): 9-23.
[2]	Lee JK,Stein SL. Radiographic and endoscopic diagnosis and treatment of enterocutaneous fistulas. Clin Colon Rectal Surg, 2010, 23(3): 149-160.
[3]	Mao R,Xu EJ,Li K, et al. Usefulness of contrast-enhanced ultrasound in the diagnosis of biliary leakage following T-tube removal. J Clin Ultrasound, 2010, 38(1): 38-40.
[4]	Alexander ES,Weinberg S,Clark RA, et al. Fistulas and sinus tracts: radiographic evaluation, management, and outcome. Gastrointest Radiol, 1982, 7(2): 135-140.
[5]	Goldman SM,Fishman EK,Gatewood OM, et al. CT in the diagnosis of enterovesical fistulae. AJR Am J Roentgenol, 1985, 144(6): 1229-1233.
[6]	Bruno O,Brancatelli G,Sauvanet A, et al. Utility of CT in the diagnosis of pancreatic fistula after pancreaticoduodenectomy in patients with soft pancreas. AJR Am J Roentgenol, 2009, 193(3): W175-W180.
[7]	Maconi G,Parente F,Bianchi Porro G. Hydrogen peroxide enhanced ultrasound-fistulography in the assessment of enterocutaneous fistulas complicating Crohn′s disease. Gut, 1999, 45(6): 874-878.
[8]	Albrecht T,Blomley M,Bolondi L, et al. Guidelines for the use of contrast agents in ultrasound: January 2004. Ultraschall Med, 2004, 25(4): 249-256.
[9]	Claudon M,Cosgrove D,Albrecht T, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS): update 2008. Ultraschall Med, 2008, 29(1): 28-44.
[10]	Dietrich CF,Braden B,Hocke M, et al. Improved characterisation of solitary solid pancreatic tumours using contrast enhanced transabdominal ultrasound. J Cancer Res Clin Oncol, 2008, 134(6): 635-643.
[11]	D′Onofrio M,Megibow AJ,Faccioli N, et al. Comparison of contrast-enhanced sonography and MRI in displaying anatomic features of cystic pancreatic masses. Am J Roentgenol, 2007, 189(6): 1435-1442.
[12]	Kitano M,Kudo M,Maekawa K, et al. Dynamic imaging of pancreatic diseases by contrast enhanced coded phase inversion harmonic ultrasonography. Gut, 2004, 53(6): 854-859.
[13]	Tamai H,Takiguchi Y,Oka M, et al. Contrast-enhanced ultrasonography in the diagnosis of solid renal tumors. J Ultrasound Med, 2005, 24(12): 1635-1640.
[14]	Mazziotti S,Zimbaro F,Pandolfo A, et al. Usefulness of contrast-enhanced ultrasonography in the diagnosis of renal pseudotumors. Abdom Imaging, 2010, 35(2): 241-245.
[15]	Piscaglia F,Nolsøe C,Dietrich CF, et al. The EFSUMB guidelines and recommendations on the clinical practice of contrast enhanced ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall Med, 2012, 33(1): 33-59.
[16]	Foschi FG,Piscaglia F,Pompili M, et al. Real-time contrast-enhanced ultrasound: a new simple tool for detection of peritoneal-pleural communications in hepatic hydrothorax. Ultraschall Med, 2008, 29(5): 538-542.
[17]	Ignee A,Baum U,Schuessler G, et al. Contrast-enhanced ultrasound-guided percutaneous cholangiography and cholangiodrainage(CEUS-PTCD). Endoscopy, 2009, 41(8): 725-726.

[1]	魏淑婕, 惠品晶, 丁亚芳, 张白, 颜燕红, 周鹏, 黄亚波. 单侧颈内动脉闭塞患者行颞浅动脉-大脑中动脉搭桥术的脑血流动力学评估[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1046-1055.
[2]	杨水华, 何桂丹, 覃桂灿, 梁蒙凤, 罗艳合, 李雪芹, 唐娟松. 胎儿孤立性完全型肺静脉异位引流的超声心动图特征及高分辨率血流联合时间-空间相关成像的应用[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1061-1067.
[3]	张璇, 马宇童, 苗玉倩, 张云, 吴士文, 党晓楚, 陈颖颖, 钟兆明, 王雪娟, 胡淼, 孙岩峰, 马秀珠, 吕发勤, 寇海燕. 超声对Duchenne肌营养不良儿童膈肌功能的评价[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1068-1073.
[4]	朱连华, 费翔, 韩鹏, 姜波, 李楠, 罗渝昆. 高帧频超声造影在胆囊息肉样病变中的鉴别诊断价值[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 904-910.
[5]	张梅芳, 谭莹, 朱巧珍, 温昕, 袁鹰, 秦越, 郭洪波, 侯伶秀, 黄文兰, 彭桂艳, 李胜利. 早孕期胎儿头臀长正中矢状切面超声图像的人工智能质控研究[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 945-950.
[6]	陈舜, 薛恩生, 叶琴. PDCA在持续改进超声危急值管理制度中的价值[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 974-978.
[7]	周钰菡, 肖欢, 唐毅, 杨春江, 周娟, 朱丽容, 徐娟, 牟芳婷. 超声对儿童髋关节暂时性滑膜炎的诊断价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 795-800.
[8]	刘欢颜, 华扬, 贾凌云, 赵新宇, 刘蓓蓓. 颈内动脉闭塞病变管腔结构和血流动力学特征分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 809-815.
[9]	郏亚平, 曾书娥. 含鳞状细胞癌成分的乳腺化生性癌的超声与病理特征分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 844-848.
[10]	张丽丽, 陈莉, 余美琴, 聂小艳, 王婧玲, 刘婷. PDCA循环法在超声浅表器官亚专科建设中的应用[J]. 中华医学超声杂志（电子版）, 2023, 20(07): 717-721.
[11]	陈旭渊, 罗仕云, 李文忠, 李毅. 腺源性肛瘘经手术治疗后创面愈合困难的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 82-85.
[12]	彭旭, 邵永孚, 李铎, 邹瑞, 邢贞明. 结肠肝曲癌的诊断和外科治疗[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 108-110.
[13]	王亮, 符谨诚, 许薇, 李彦庆, 郭永波, 邹科见. 直肠成熟囊性畸胎瘤伴直肠阴道瘘一例并文献复习[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 117-118.
[14]	袁媛, 赵良平, 刘智慧, 张丽萍, 谭丽梅, 閤梦琴. 子宫内膜癌组织中miR-25-3p、PTEN的表达及与病理参数的关系[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1016-1020.
[15]	李田, 徐洪, 刘和亮. 尘肺病的相关研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(08): 900-905.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Value of intracavitary contrast-enhanced ultrasound in the diagnosis of fistulas

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Value of intracavitary contrast-enhanced ultrasound in the diagnosis of fistulas