Harmonic US imaging of appendicitis in children

Area of Science:

• Pediatric imaging
• Medical ultrasound technology
• Gastrointestinal diagnostics

Background:

• Harmonic imaging (HI) enhances ultrasound image quality, improving contrast and resolution.
• While effective in adults, HI's utility in pediatric abdominal sonography, particularly for intestinal conditions, is less established.
• Existing pediatric studies on HI are limited and do not cover intestinal sonography.

Purpose of the Study:

• To compare the sonomorphological image quality of harmonic imaging (HI) versus fundamental imaging (FI) in diagnosing pediatric appendicitis.
• To evaluate the effectiveness of HI in visualizing the appendix and surrounding structures in children.

Main Methods:

• A prospective comparative study involving 50 children suspected of appendicitis.
• Preoperative ultrasound examinations using both FI and HI (tissue harmonic imaging, THI) were performed.
• Image quality was scored based on parameters like appendiceal contour, wall, mucosa, contents, and periappendiceal findings.

Main Results:

• Histological confirmation of acute appendicitis in 86% of cases.
• HI depicted the inflamed appendix in 93% of cases, compared to 86% with FI.
• HI demonstrated significantly superior visualization of the appendix (contour, wall, mucosa, contents) and periappendiceal features (free fluid, lymph nodes, bowel wall).

Conclusions:

• Harmonic imaging (HI) is the preferred ultrasound modality for evaluating suspected acute appendicitis in children.
• HI enhances the definitive diagnosis of acute appendicitis by providing clearer imaging of the appendix and surrounding tissues.
• The findings support the expanded use of HI in pediatric gastrointestinal imaging.