Contrast enhanced Colostography: new applications in preoperative evaluation of Anorectal malformation
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In brief
In brief
Contrast-enhanced colostography using ultrasound provides radiation-free, high-resolution 3D imaging for preoperative planning in anorectal malformations. In 14 pediatric patients, this technique matched or exceeded traditional imaging in 93% of cases, detecting fistulas missed by conventional methods in 15% of patients.
Written by the GCMD Library team from the article.
Abstract
Introduction
Understanding details of anatomic relationships between the colon and surrounding structures is a critical piece of preoperative planning prior to surgical repair of anorectal malformations (ARMs).
Traditional imaging techniques involve ionizing radiation, distention of the rectum with supraphysiologic intraluminal pressures, and sometimes require sedation. Recent developments in the field of contrast agents have allowed the emergence of an ultrasound-based technique that can avoid these requirements while continuing to provide high resolution structural information in three dimensions.
Methods
Fourteen children (13 male, 1 female, age 1–11 months) with ARMs underwent contrast enhanced colostography (ceCS) in addition to traditional preoperative imaging techniques to delineate anatomic relationships of pelvic structures.
Results
ceCS and traditional imaging yielded concordant anatomic information, including structural relationships and fistulous connections, in 10/14 patients (71%). ceCS detected fistulous connection in 2/13 patients (15%) that were not seen by traditional imaging. Ultrasonography failed to detect the fistulous connection in one patient.
Conclusions
ceCS is a safe, effective and flexible method for defining important structural information in ARM patients. When compared with traditional methods, it provided equivalent or superior results 93% of the time and bears consideration as a standard tool in preoperative planning for this population.
Type of Study
Retrospective Comparative Study.
Level of Evidence
Level III.