A unique 3D endoanal ultrasound feature of perianal Crohn%26apos;s fistula: the Crohn ultrasound fistula sign%26apos;

作者：Zawadzki A^*; Starck M; Bohe M; Thorlacius H

来源：Colorectal Disease, 2012, 14(9): e608-e611.

DOI：10.1111/j.1463-1318.2012.03047.x

• Crohn%26apos
• s disease
• perianal fistula
• 3D ultrasound

Aim Using a high-resolution 3D endoanal ultrasound, we have observed that some perianal fistulas show a hypoechogenic fistula tract surrounded by a well-defined hyperechogenic area with a thin hypoechogenic edge in patients with Crohns disease [Crohns Ultrasound Fistula Sign (CUFS)], unlike conventional fistula tracks. The study aimed to determine the prevalence of CUFS in a consecutive series of patients with anal fistula. Method Of 157 patients (median age 45, range 1486 years, 100 males) with perianal fistula were examined with 3D endoanal ultrasound. All 3D volumes were stored and analysed retrospectively by two independent observers blinded to the clinical information of the patients. Results There were 29 patients with Crohns disease of whom 20 (69%) showed CUFS. CUFS was absent in 125 (98%) of 128 patients without Crohns disease. The positive and negative predictive value of CUFS for Crohns disease was 87% and 93%, respectively. The kappa value of the two independent observers was 0.77, indicating a substantial interobserver agreement. Conclusion This study provides a new 3D endoanal ultrasound criterion, CUFS, of perianal fistula in patients with Crohns disease. The sign can be used to discriminate a Crohns from other types of fistula, which may be useful in the management of patients with anal fistula.

• 出版日期2012-9