| 林静,张文静,覃斯,刘小银,陈瑶,余俊丽,王怡敏,刘广健.对比MRI与直肠腔内超声诊断直肠阴道瘘[J].中国医学影像技术,2020,36(5): |
| 对比MRI与直肠腔内超声诊断直肠阴道瘘 |
| Comparison of MRI and endorectal ultrasonography in diagnosis of rectovaginal fistula |
| 投稿时间：2019-06-04 修订日期：2020-05-18 |
| DOI： |
| 中文关键词: 直肠阴道瘘 腔内超声 磁共振成像 诊断 |
| 英文关键词:rectovaginal fistula endosonography magnetic resonance imaging diagnosis |
| 基金项目:无 |
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| 摘要点击次数: 1925 |
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| 中文摘要: |
| 目的 比较MRI和直肠腔内超声（ERUS）对直肠阴道瘘(RVF)的诊断价值。方法 回顾性分析51例术前MRI和ERUS疑诊RVF患者，分别根据病因及复杂程度对瘘管进行分类；以手术结果为标准，比较MRI和ERUS诊断RVF的敏感度、特异度、准确率及其对各种类型RVF的检出率，分析MRI、ERUS诊断结果与手术结果的一致性以及MRI与ERUS二者之间诊断结果的一致性。结果 经手术证实40例存在RVF。MRI诊断RVF的敏感性、特异度、准确率（85.00%、90.90%、86.27%）与ERUS（80.00%、100.00%、84.31% ）相比差异均无统计学意义 (χ2=0.17、＜0.01、＜0.01，P均＞0.05)。MRI、ERUS诊断结果与手术结果的一致性较高（Kappa=0.65、0.63，P均＜0.05）；二者之间诊断结果的一致性亦较高（Kappa=0.70，P＜0.05）。MRI及ERUS对单纯性瘘的检出率均为100%，对复杂性瘘的检出率差异无统计学意义（χ2=0.17，P=0.69），2中方法结合，对复杂性瘘的检出率提高至88.57%（31/35）。MRI与ERUS对不同病因所致RVF检出率差异无统计学意义（P均＞0.05）。结论 MRI及ERUS均可用于诊断RVF，对单纯性RVF建议以ERUS为首选检查方式。对于复杂性RVF，联合应用两种影像学方法可提高检出率。 |
| 英文摘要: |
| Objective To compare the value of magnetic resonance imaging (MRI) and endorectal ultrasonography (ERUS) in the diagnosis of rectovaginal fistula (RVF). Methods 51 patients suspected RVF were investigated by MRI and ERUS before operation. According to the results of surgical exploration, the diagnostic efficacy and consistency of MRI and ERUS in RVF were analyzed and compared. Results RVF was detected in 40 patients. The sensitivity, specificity and accuracy were 85.00%, 90.90% and 86.27% for MRI, 80.00%, 100.00% and 84.31% for ERUS, respectively. There was no statistically significant difference between ERUS and MRI (P＞0.05). Both MRI and ERUS were substantially consistent with surgical diagnosis (Kappa =0.65，0.63, respectively). The overall diagnostic consistency between ERUS and MRI was good(Kappa = 0.70). The detection rate of simple fistula on MRI and ERUS were both 100.00%, and that of complicated fistula were 82.86% and 77.14%, respectively. Although no significant difference was found between MRI and ERUS in diagnosis of complicated fistula(P=0.69), the consistency between them was moderate（Kappa = 0.47）. Conclusion Both MRI and ERUS show high performance on the diagnosis of RVF, with relative low detection rate and diagnostic consistency for complicated fistula. We suggest that ERUS should be the first choice for simple RVF and it is necessary to combine both MRI and ERUS in evaluation of complicated RVF. |
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