초록 close

최근에 항문 초음파 검사가 항문조임근의 영상을 볼 수 있어 항문질환의 진단목적으로 점점 그 사용이 많아 지고 있다. 장점으로는 외래에서 비교적 신속하게 통증을 유발 하지 않고 시행이 가능하다. 항문관의 상부에서부터 하부 방향으로 탐촉자를 진행하면서 각 부위에서의 영상을 얻 으면 된다. 내항문근은 원형의 저에코 띠 모양으로 보이는 데 항문관의 중간부위에서 가장 뚜렷하게 보인다. 외항문 근은 저에코의 내항문근 바깥으로 조금 더 두꺼운 혼합성 고에코의 원형 띠로 나타난다. 항문 초음파 검사는 농양 동 반 여부에 관계없이 항문 치루 평가에 유용하다. 저에코로 보이는 치루관이나 농양이 항문조임근의 영상과 연계하여 외항문근층에 있다든지 ischiorectal fossa에 있다든지 등 의 정확한 위치를 알 수 있다. 그외에도 변실금 원인 진단 에도 아주 유용한 검사로 대두되고 있다. 각 환자의 변실금 기전과 연계한 생리적 겸사 결과와 더불어 항문 초음파검 사 결과를 종합하여 좀 더 정확한 변실금의 원인을 진단할 수 있으며 또한 조임근성형술 (sphincteroplasty) 후의 결 과추적에도 초음파 검사를 이용할 수 있다. 저자들은 항문 관 부위에 따른 정상 초음파 영상과 각 항문주위 질환의 영 상소견을 보고하고자 한다.


Endoanal ultrasonography has recently emerged as a popular diagnostic modality for mapping and imaging the anal sphincter. This procedure can be performed as an outpatient procedure; it is relatively quick and virtually painless. The imaging typically is performed in a proximal to distal manner with defining a variety of levels of the anal canal as it progresses. Anal ultrasond can provide a detailed image of the anal sphincter musculature. The internal anal sphincter appears endosonographically as a hypoechoic circular band that is most prominently seen at the level of the mid-anal canal. The external anal sphincter appears as a thicker circular mixed echogenic band outside of the hypoechoic internal sphincter. Anal ultrasond can be used to evaluate patients with anal fistulas with or without abscess. Imaging is performed and the fistulous tracts or abscesses are identified by hypoechogenicity within the external sphincter muscle or the ischiorectal fossa. Its ability to clearly image the anal sphincters has allowed its use for the evaluation of anal fistulas. Moreover, anal ultrasound has emerged as the technique of choice for imaging the anal sphincters and for evaluating incontinence. Each of the individual physiologic tests offers valuable information that is relevant to the continence mechanism, and the ultrasound yields results that are complementary to other tests. Ultrasound serves as a surveillance tool to monitor the results after sphincterplasty. We illustrate the endo-anal sonographic features of various anal diseases and the ultrasound-anatomic correlation for the anus.


Endoanal ultrasonography has recently emerged as a popular diagnostic modality for mapping and imaging the anal sphincter. This procedure can be performed as an outpatient procedure; it is relatively quick and virtually painless. The imaging typically is performed in a proximal to distal manner with defining a variety of levels of the anal canal as it progresses. Anal ultrasond can provide a detailed image of the anal sphincter musculature. The internal anal sphincter appears endosonographically as a hypoechoic circular band that is most prominently seen at the level of the mid-anal canal. The external anal sphincter appears as a thicker circular mixed echogenic band outside of the hypoechoic internal sphincter. Anal ultrasond can be used to evaluate patients with anal fistulas with or without abscess. Imaging is performed and the fistulous tracts or abscesses are identified by hypoechogenicity within the external sphincter muscle or the ischiorectal fossa. Its ability to clearly image the anal sphincters has allowed its use for the evaluation of anal fistulas. Moreover, anal ultrasound has emerged as the technique of choice for imaging the anal sphincters and for evaluating incontinence. Each of the individual physiologic tests offers valuable information that is relevant to the continence mechanism, and the ultrasound yields results that are complementary to other tests. Ultrasound serves as a surveillance tool to monitor the results after sphincterplasty. We illustrate the endo-anal sonographic features of various anal diseases and the ultrasound-anatomic correlation for the anus.