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Ultra high frequency ultrasonography to distinguish ganglionic from aganglionic bowel wall in Hirschsprung disease : A first report

Granéli, Christina LU ; Erlöv, Tobias LU ; Mitev, Rodrigo Munoz ; Kasselaki, Ioanna LU ; Hagelsteen, Kristine LU orcid ; Gisselsson, David LU ; Jansson, Tomas LU ; Cinthio, Magnus LU and Stenström, Pernilla LU orcid (2021) In Journal of Pediatric Surgery 56(12). p.2281-2285
Abstract

Background/Purpose: In Hirschsprung disease (HD) surgery, confirming ganglionic bowel is essential. A faster diagnostic method than the current frozen biopsy is desirable. This study investigated whether aganglionic and ganglionic intestinal wall can be distinguished from each other by ultra high frequency ultrasound (UHF ultrasound). Methods: In an HD center during 2019, intestinal walls of recto-sigmoid specimens from HD patients were examined ex vivo with a 70 MHz UHF ultrasound transducer. Data from four sites were described. Histopathologic analysis was compared to the ultrasonography outcome at each site. Each patient's specimen served as its own control. Results: 11 resected recto-sigmoid specimens (median 20 cm long [range... (More)

Background/Purpose: In Hirschsprung disease (HD) surgery, confirming ganglionic bowel is essential. A faster diagnostic method than the current frozen biopsy is desirable. This study investigated whether aganglionic and ganglionic intestinal wall can be distinguished from each other by ultra high frequency ultrasound (UHF ultrasound). Methods: In an HD center during 2019, intestinal walls of recto-sigmoid specimens from HD patients were examined ex vivo with a 70 MHz UHF ultrasound transducer. Data from four sites were described. Histopathologic analysis was compared to the ultrasonography outcome at each site. Each patient's specimen served as its own control. Results: 11 resected recto-sigmoid specimens (median 20 cm long [range 6.5–33]) with transition zones of 5 cm (2–11 cm) were taken from children aged 22 days (13–48) weighing 3668 g (3500–5508); 44 key sites were analyzed. There was full concordance for 42/44 (95%) key sites and 10 of 11 (91%) specimens. The specimen with discordance of two key sites contained a segment of aganglionosis (3 cm) and a transition zone (1 cm): the site discordance was limited to the transition zone ends. Conclusions: This first report on UHF ultrasound in recto-sigmoid HD shows promising results in identifying aganglionosis, transition zones and ganglionic bowel. Further in vivo studies are required.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Differential diagnosis, Ganglionic bowel, Hirschsprung disease, Ultrasonography
in
Journal of Pediatric Surgery
volume
56
issue
12
pages
2281 - 2285
publisher
Elsevier
external identifiers
  • pmid:33676743
  • scopus:85101976503
ISSN
0022-3468
DOI
10.1016/j.jpedsurg.2021.02.011
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
id
a0c3bff4-4285-445e-b158-0be8403be258
date added to LUP
2021-03-26 09:54:17
date last changed
2024-06-15 08:27:11
@article{a0c3bff4-4285-445e-b158-0be8403be258,
  abstract     = {{<p>Background/Purpose: In Hirschsprung disease (HD) surgery, confirming ganglionic bowel is essential. A faster diagnostic method than the current frozen biopsy is desirable. This study investigated whether aganglionic and ganglionic intestinal wall can be distinguished from each other by ultra high frequency ultrasound (UHF ultrasound). Methods: In an HD center during 2019, intestinal walls of recto-sigmoid specimens from HD patients were examined ex vivo with a 70 MHz UHF ultrasound transducer. Data from four sites were described. Histopathologic analysis was compared to the ultrasonography outcome at each site. Each patient's specimen served as its own control. Results: 11 resected recto-sigmoid specimens (median 20 cm long [range 6.5–33]) with transition zones of 5 cm (2–11 cm) were taken from children aged 22 days (13–48) weighing 3668 g (3500–5508); 44 key sites were analyzed. There was full concordance for 42/44 (95%) key sites and 10 of 11 (91%) specimens. The specimen with discordance of two key sites contained a segment of aganglionosis (3 cm) and a transition zone (1 cm): the site discordance was limited to the transition zone ends. Conclusions: This first report on UHF ultrasound in recto-sigmoid HD shows promising results in identifying aganglionosis, transition zones and ganglionic bowel. Further in vivo studies are required.</p>}},
  author       = {{Granéli, Christina and Erlöv, Tobias and Mitev, Rodrigo Munoz and Kasselaki, Ioanna and Hagelsteen, Kristine and Gisselsson, David and Jansson, Tomas and Cinthio, Magnus and Stenström, Pernilla}},
  issn         = {{0022-3468}},
  keywords     = {{Differential diagnosis; Ganglionic bowel; Hirschsprung disease; Ultrasonography}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{12}},
  pages        = {{2281--2285}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Pediatric Surgery}},
  title        = {{Ultra high frequency ultrasonography to distinguish ganglionic from aganglionic bowel wall in Hirschsprung disease : A first report}},
  url          = {{http://dx.doi.org/10.1016/j.jpedsurg.2021.02.011}},
  doi          = {{10.1016/j.jpedsurg.2021.02.011}},
  volume       = {{56}},
  year         = {{2021}},
}