Transperineal Ultrasound for Perianal Fistulas and Abscesses - A Systematic Review and Meta-Analysis.
Ultraschall Med
; 38(3): 265-272, 2017 Jun.
Article
in En
| MEDLINE
| ID: mdl-28399604
ABSTRACT
Purpose Transperineal ultrasound (TPUS) is a practical tool for assessing perianal inflammatory lesions. We systematically review its accuracy for detecting and classifying perianal fistulae and abscesses. Method The National Library of Medicine and Embase were searched for articles on TPUS for the assessment of idiopathic and Crohn's perianal fistulae and abscesses. Two reviewers independently reviewed eligible studies and rated them for quality using the QUADAS tool. The primary outcome measure was the accuracy of TPUS as measured by its sensitivity and positive predictive value (PPV) in detecting and classifying perianal fistulae, internal openings and perianal abscesses. Results We included 12 studies (565 patients). Overall, the methodological quality of the studies was suboptimal. 3 studies were retrospective and 4 showed significant risks of bias in the application of the reference standard. The sensitivity of TPUS in detecting perianal fistulae on a per-lesion basis was 98â% (95â% CI 96â-â100â%) and the PPV was 95â% (95â% CI 90â-â98â%). The detection of internal openings had a sensitivity of 91â% (95â% CI 84â-â97â%) with a PPV of 87â% (95â% CI 76â-â95â%). The classification of fistulae yielded a sensitivity of 92â% (95â% CI 85â-â97â%) and a PPV of 92â% (95â% CI 83â-â98â%). TPUS had a sensitivity of 86â% (95â% CI 67â-â99â%) and PPV of 90â% (95â% CI 76â-â99â%) in the detection of perianal abscesses. Conclusion The current literature on TPUS illustrates good overall accuracy in the assessment of perianal fistulae and abscesses. However, many studies had methodological flaws suggesting that further research is required.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Anus Diseases
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Rectal Fistula
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Endosonography
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Abscess
Type of study:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Limits:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Child, preschool
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
Ultraschall Med
Year:
2017
Document type:
Article
Affiliation country:
Italia