Ultrasonography with the colonic segment-approach for colonic polyps in children

• Published in: Pediatric radiology Vol. 49; no. 13; pp. 1735 - 1741
• Main Authors: Wang, Yu, Wang, Xiao Man, Jia, Li Qun
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2019; Springer Nature B.V
• Subjects: Age Factors; Child; Child, Preschool; Children; Cohort Studies; Colon; Colonic Polyps - diagnostic imaging; Colonic Polyps - epidemiology; Colonic Polyps - pathology; Colonoscopy; Colonoscopy - methods; Confidence Intervals; Diagnosis; Diagnostic systems; Female; Follow-Up Studies; Gold; Humans; Imaging; Male; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Observer Variation; Oncology; Original Article; Pediatrics; Polyps; Radiology; Rectum; Retrospective Studies; Risk Assessment; Sensitivity; Sensitivity and Specificity; Severity of Illness Index; Statistics, Nonparametric; Ultrasonic imaging; Ultrasonic testing; Ultrasonography, Doppler - methods; Ultrasound; United States; United States; United States > US; Accuracy; Children; Colon; Reliability; Polyps; Ultrasonography
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s00247-019-04498-y

Background Ultrasonography (US) has been widely applied and has validated efficacy in the diagnosis of colonic polyps in children. However, little attention has been paid to improving the detection rate of polyps, optimizing the ultrasonic examination process and reducing misdiagnosis. Objective To investigate the diagnostic performance of the colonic segment-approach by US in the diagnosis of colonic polyps in pediatric patients. Materials and methods One hundred fifty-nine patients who were going to have a colonoscopy from September 2014 to August 2016 were enrolled in this study. All patients received US before colonoscopy. In a preliminary study, 50 patients were chosen to determine the interobserver agreement, with half of the cases with and half of the cases without a colonic segment-approach. The other 109 patients were examined by both approaches. The sensitivity and the specificity of each approach were compared based on the outcome of colonoscopy as the gold criteria. Results The interobserver agreement was high (0.816 for the non-segmental approach, 0.754 for the colonic segment-approach). The diagnostic sensitivity of the colonic segment-approach was higher than that of the traditional approach (82.1% vs. 57.7%, P <0.05) with 89.3% vs. 64.2% detection rate of colonic polyps in the descending colon, 81.8% vs. 60.6% in the sigmoid colon, and 81.3% vs. 43.8% in the rectum, respectively. The specificity of both methods was 100% (95% confidence interval: 86.3%-100%). Conclusion The US colonic segment-approach can improve diagnostic sensitivity for colonic polyps as a convenient method with no special requirement for equipment and examination conditions.