Comparative Effectiveness of Imaging Modalities for Preoperative Assessment of Anorectal Malformation in the Pediatric Population
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In brief
In brief
This retrospective study of 84 pediatric ARM patients demonstrates MRI's superior diagnostic accuracy compared to X-ray and colostography for preoperative assessment. MRI showed significantly better detection of spinal anomalies and Pena classification, while also identifying associated genitourinary abnormalities and sphincter complex development in a substantial proportion of cases.
Written by the GCMD Library team from the article.
Objective
The aim of this study was to compare the accuracy of MRI, colostography/fistulography, and X-ray imaging modalities for preoperative diagnosis of anorectal malformations (ARMs) in pediatric patients.
Methods
This retrospective analysis included a total of 84 pediatric patients with ARMs. Preoperative imaging findings were assessed by 2 radiologists and compared to surgical findings.
Results
MRI identified anomalies of the spine in 25 of 84 patients (29.8%), anomalies of the genital system in 7 of 84 patients (8.3%), anomalies of the urinary system in 22 of 84 patients (26.2%), and underdeveloped sphincter muscle complex in 34 of 84 patients (40.5%). In the 44 subjects receiving both MRI and X-ray, MRI was more sensitive in detecting anomalies of spine (18/44 vs. 8/44; P = 0.002), and both correctly identified the distal end of the rectum in 77.3% (34/44) of the cases. In the 24 subjects receiving both MRI and colostography/fistulography, MRI was more accurate in identifying Pena's classification (22/24 vs. 15/24; P = 0.039). Distal end of the rectum was correctly identified in 75.0% (18/24) and 58.3% (14/24) of the cases (P = 0.125).
Conclusions
MRI could clearly reveal fistula anatomy and associated anomalies of ARMs and should be routinely used for preoperative evaluation of ARMs.
Type of study
Study of diagnostic test.
Level of evidence
Level II.