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Sonographic diagnosis of colorectal polyps in children: Diagnostic accuracy and multi-factor combination evaluation
Ni-Na Qu1,2, Rui-Hua Liu1, Lei Shi1
1Department of Ultrasound, Affiliated Yantai Yuhuangding Hospital of Qingdao University.
Insights
Ultrasonography is a safe and accurate primary screening tool for pediatric colorectal polyps. Basic colon preparation with glycerine enema significantly improves detection rates, making it a recommended step before examination.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Colorectal Health
Background:
- Colorectal polyps in children require accurate and safe diagnostic methods.
- The role of ultrasonography and the necessity of colonic preparation for polyp detection in pediatric patients were unclear.
Purpose of the Study:
- To evaluate the diagnostic value of ultrasonography in screening colorectal polyps in children.
- To determine the necessity of colonic preparation before ultrasonic examination for pediatric colorectal polyps.
Main Methods:
- Retrospective review of 288 children diagnosed with colorectal polyps between 2007 and 2016.
- Comparison of ultrasonography findings before and after basic colon preparation (glycerine enema).
- Confirmation of polyps via colonoscopy/laparotomy and histopathology.
Main Results:
- Ultrasonography detected 91.67% of solitary polyps and 90% of multiple polyps.
- With glycerine enema preparation, ultrasonography detected 94.96% of polyps, significantly increasing detection rates (P < .0001).
- Sensitivity and specificity of ultrasonography with preparation were 94.96% and 100%, respectively.
Conclusions:
- Ultrasonography is a safe, valid, and accurate primary diagnostic method for screening pediatric colorectal polyps.
- Basic colon preparation with glycerine enema is recommended to enhance the detection of intraluminal lesions in children.
Abstract:
This study was established to evaluate the diagnostic value of ultrasonography in screening colorectal polyps in children and to discuss the necessity of colonic preparation before an ultrasonic examination.In this study, 288 children with colorectal polyps managed at our hospital between January 2007 and December 2016 were retrospectively reviewed. All patients were examined before and after basic colon preparation. The colorectal polyps were confirmed by colonoscopy/laparotomy and histopathology. Among all 288 patients, solitary polyps were identified in 278 patients (96.52%), and multiple polyps were identified in 10 patients (43 polyps) (3.48%) by colonoscopy/laparotomy and histopathology.By ultrasonic examination, 264 cases (264/278) were detected as solitary polyp and 9 cases (9/10) as multiple polyps (31 polyps). In 278 solitary polyps, 180 (64.74%) were detected by ultrasonic examination without a colon preparation. Following glycerine enema (10-20 mL) treatment, 264 (94.96%) cases were detected by ultrasonic examination. The sensitivity and specificity of ultrasonography with glycerine enema for the detection of colorectal polyps were 94.96% and 100%, respectively. Colon preparation significantly increased the proportion of polyps identified by ultrasonography (P < .0001), as well as the diagnostic rate of polyps in rectum, sigmoid colon and descending colon (P < .05).Ultrasonography can be the primary diagnostic method for screening colorectal polyps in children on the strength of its safety, validity, and accuracy. Basic colon preparation with glycerine enema is recommended for children, which enable the detection of intraluminal lesions before ultrasonic examination.
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