AIM： To evaluate the effectiveness of three-dimensional endoanal ultrasound （3D-EAUS） in the assessment of anal fistulae with and without H202 enhancement. METHODS： Sixty-one patients （37 males, aged 17-74 years...AIM： To evaluate the effectiveness of three-dimensional endoanal ultrasound （3D-EAUS） in the assessment of anal fistulae with and without H202 enhancement. METHODS： Sixty-one patients （37 males, aged 17-74 years） with anal fistulae, which were not simple low types, were evaluated by physical examination and 3D-EAUS with and without enhancement. Fistula classification was determined with each modality and compared to operative findings as the reference standard. RESULTS： The accuracy of 3D-EAUS was significantly higher than that of physical examination in detecting the primary tract （84.4% vs 68.7%, P = 0.037） and secondary extension （81.8% vs 62.1%, P = 0.01） and localizing the internal opening （84.2% vs 59.7%, P = 0.004）. A contrast study with H202 detected several more fistula components including two primary suprasphincteric fistula tracks and one supralevator secondary extension, which were not detected on non-contrast study. However, there was no significant difference in accuracy between 3D-EAUS and H202- enhanced 3D-EAUS with respect to classification of the primary tract （84.4% vs 89.1%, P = 0.435） or secondary extension （81.8% vs 86.4%, P = 0.435） or localization of the internal opening （84.2% vs 89.5%, P = 0.406）. CONCLUSION： 3D-EAUS was highly reliable in the diagnosis of an anal fistula. H2O2 enhancement was helpful at times and selective use in difficult cases may be economical and reliable.展开更多
文摘AIM： To evaluate the effectiveness of three-dimensional endoanal ultrasound （3D-EAUS） in the assessment of anal fistulae with and without H202 enhancement. METHODS： Sixty-one patients （37 males, aged 17-74 years） with anal fistulae, which were not simple low types, were evaluated by physical examination and 3D-EAUS with and without enhancement. Fistula classification was determined with each modality and compared to operative findings as the reference standard. RESULTS： The accuracy of 3D-EAUS was significantly higher than that of physical examination in detecting the primary tract （84.4% vs 68.7%, P = 0.037） and secondary extension （81.8% vs 62.1%, P = 0.01） and localizing the internal opening （84.2% vs 59.7%, P = 0.004）. A contrast study with H202 detected several more fistula components including two primary suprasphincteric fistula tracks and one supralevator secondary extension, which were not detected on non-contrast study. However, there was no significant difference in accuracy between 3D-EAUS and H202- enhanced 3D-EAUS with respect to classification of the primary tract （84.4% vs 89.1%, P = 0.435） or secondary extension （81.8% vs 86.4%, P = 0.435） or localization of the internal opening （84.2% vs 89.5%, P = 0.406）. CONCLUSION： 3D-EAUS was highly reliable in the diagnosis of an anal fistula. H2O2 enhancement was helpful at times and selective use in difficult cases may be economical and reliable.
