Abstract：
OBJECTIVE: To evaluate the feasibility of intraoperative transurethral contrast-enhanced ultrasound for the assessment of male urethral fistulas.
METHODS: Patients in a prospective database who underwent intraoperative two-dimensional ultrasound, transurethral saline-enhanced ultrasound, and contrast-enhanced ultrasound between January 2017 and July 2022 were included. All patients were clinically diagnosed with urethral fistulae (UF) in the outpatient setting based on clinical presentations, traditional two-dimensional ultrasound, and/or other imaging modalities and confirmed during surgical repair. Dynamic videos of the scans were independently analyzed by two experienced ultrasonologists.
RESULTS: Thirty-nine patients with an average age of 51 years were included. The UF were located in the anterior urethra in 22 (56.4%) patients and in the bulbar urethra in 14 (63.6%) patients. UF were located in the posterior urethra in 17 (436%) patients and in the prostatic urethra in 13 (76.5%) patients. Contrast-enhanced ultrasonography revealed UF in all patients. In patients with anterior UF, saline-enhanced ultrasound images did not show a UF in 15 (68.2%, 15/22) patients, 13 (86.7%, 13/15) of whom had fistulae with diameters <3 mm. Saline-enhanced ultrasound images did not reveal posterior UF in 13 (76.5%, 13/17) patients. The fistula diameters in eight (61.5%, 8/13) patients were <3 mm. The duration for contrast-enhanced ultrasonography was approximately 3 minutes. The duration for surgical repair was approximately 2 hours.
CONCLUSIONS: Transurethral contrast-enhanced ultrasound is a real-time, noninvasive, and radiation-free method that allows intraoperative imaging and accurate assessment of male UF. Its sensitivity is higher than that of both two-dimensional ultrasound and transurethral saline-enhanced ultrasound. The location, size, and course of the fistulae can be clearly seen due to greater contrast during contrast-enhanced ultrasound.
METHODS: Patients in a prospective database who underwent intraoperative two-dimensional ultrasound, transurethral saline-enhanced ultrasound, and contrast-enhanced ultrasound between January 2017 and July 2022 were included. All patients were clinically diagnosed with urethral fistulae (UF) in the outpatient setting based on clinical presentations, traditional two-dimensional ultrasound, and/or other imaging modalities and confirmed during surgical repair. Dynamic videos of the scans were independently analyzed by two experienced ultrasonologists.
RESULTS: Thirty-nine patients with an average age of 51 years were included. The UF were located in the anterior urethra in 22 (56.4%) patients and in the bulbar urethra in 14 (63.6%) patients. UF were located in the posterior urethra in 17 (436%) patients and in the prostatic urethra in 13 (76.5%) patients. Contrast-enhanced ultrasonography revealed UF in all patients. In patients with anterior UF, saline-enhanced ultrasound images did not show a UF in 15 (68.2%, 15/22) patients, 13 (86.7%, 13/15) of whom had fistulae with diameters <3 mm. Saline-enhanced ultrasound images did not reveal posterior UF in 13 (76.5%, 13/17) patients. The fistula diameters in eight (61.5%, 8/13) patients were <3 mm. The duration for contrast-enhanced ultrasonography was approximately 3 minutes. The duration for surgical repair was approximately 2 hours.
CONCLUSIONS: Transurethral contrast-enhanced ultrasound is a real-time, noninvasive, and radiation-free method that allows intraoperative imaging and accurate assessment of male UF. Its sensitivity is higher than that of both two-dimensional ultrasound and transurethral saline-enhanced ultrasound. The location, size, and course of the fistulae can be clearly seen due to greater contrast during contrast-enhanced ultrasound.
摘要：
目的：探讨经尿道超声造影评估男性尿道瘘的可行性。
方法：前瞻性数据库中接受术中二维超声检查的患者，经尿道盐水超声增强,纳入了2017年1月至2022年7月期间的超声造影检查.根据临床表现，所有患者在门诊均被临床诊断为尿道瘘（UF）。传统的二维超声，和/或其他成像方式，并在手术修复期间确认。由两名经验丰富的超声医师独立分析扫描的动态视频。
结果：纳入39例患者，平均年龄51岁。UF位于22例（56.4％）患者的前尿道和14例（63.6％）的球尿道。UF位于17例（436％）患者的后尿道和13例（76.5％）患者的前列腺尿道中。超声造影显示所有患者都有UF。在前UF患者中，盐水增强超声图像未显示UF在15(68.2%，15/22）患者，13（86.7%，13/15），其中瘘管直径<3mm。盐水增强超声图像未显示13例的后部UF（76.5％，13/17）患者。瘘管直径在8个（61.5%，8/13)患者均<3mm。超声造影的持续时间约为3分钟。手术修复的持续时间约为2小时。
结论：经尿道超声造影是一种实时、非侵入性，和无辐射方法，允许术中成像和准确评估男性UF。其灵敏度高于二维超声和经尿道盐水增强超声。位置,尺寸,并且由于在对比增强超声期间更大的对比度，可以清楚地看到瘘的过程。
方法：前瞻性数据库中接受术中二维超声检查的患者，经尿道盐水超声增强,纳入了2017年1月至2022年7月期间的超声造影检查.根据临床表现，所有患者在门诊均被临床诊断为尿道瘘（UF）。传统的二维超声，和/或其他成像方式，并在手术修复期间确认。由两名经验丰富的超声医师独立分析扫描的动态视频。
结果：纳入39例患者，平均年龄51岁。UF位于22例（56.4％）患者的前尿道和14例（63.6％）的球尿道。UF位于17例（436％）患者的后尿道和13例（76.5％）患者的前列腺尿道中。超声造影显示所有患者都有UF。在前UF患者中，盐水增强超声图像未显示UF在15(68.2%，15/22）患者，13（86.7%，13/15），其中瘘管直径<3mm。盐水增强超声图像未显示13例的后部UF（76.5％，13/17）患者。瘘管直径在8个（61.5%，8/13)患者均<3mm。超声造影的持续时间约为3分钟。手术修复的持续时间约为2小时。
结论：经尿道超声造影是一种实时、非侵入性，和无辐射方法，允许术中成像和准确评估男性UF。其灵敏度高于二维超声和经尿道盐水增强超声。位置,尺寸,并且由于在对比增强超声期间更大的对比度，可以清楚地看到瘘的过程。
