Ultrasonographic Diagnostic Value of Perianal Mucinous Adenocarcinoma (with 1 Case Report)

目的：探讨超声在肛周粘液腺癌诊断中的应用价值。方法：回顾性分析1例肛周粘液腺癌的超声影像学特诊及临床资料，并结合相关国内外文献进行分析总结。结果：本例超声显示为坐骨肛门窝区不均质回声团块(4.3 cm × 3.0 cm × 1.7 cm)，边界模糊，形态欠规则，其内见散在小无回声区；彩色多普勒示其内血流信号丰富，阻力指数RI = 1.0。MRI提示混杂高信号占位，术后病理确诊为粘液腺癌。结论：肛周部粘液腺癌超声多表现为实性为主的不均质肿块，部分表现为多房或网格状混合回声肿块，常合并肛瘘，血流阻力指数较高。超声结合MRI检查有助于早期鉴别诊断，超声引导下穿刺活检可提高确诊率。Objective: To investigate the application value of ultrasound in the diagnosis of perianal mucinous adenocarcinoma. Methods: A retrospective analysis was performed on the ultrasonic imaging characteristics and clinical data of 1 case of perianal mucinous adenocarcinoma, combined with a review and summary of relevant domestic and foreign literatures. Results: Ultrasound in this case showed a heterogeneous echo mass (4.3 cm × 3.0 cm × 1.7 cm) in the ischioanal fossa area, with blurred boundaries and irregular shape. Scattered small anechoic areas were observed within the mass. Color Doppler ultrasound showed rich blood flow signals, with a resistance index (RI) of 1.0. MRI suggested a mixed hyperintense space-occupying lesion, and postoperative pathology confirmed mucinous adenocarcinoma. Conclusion: Perianal mucinous adenocarcinoma often manifests as a solid-based heterogeneous mass on ultrasound, and some cases show multi-locular or reticular mixed echo masses, often combined with anal fistula, and the blood flow resistance index is relatively high. Ultrasound combined with MRI examination is helpful for early differential diagnosis, and ultrasound-guided puncture biopsy can improve the diagnostic accuracy.