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Shear wave elastography evaluation in predicting the success of ultrasound-guided saline enema hydrostatic reduction
İsmail Akdulum1, Enes Gürün2, Melih Akyüz3
1Department of Pediatric Radiology, Gazi University, Ankara, Turkey.
Insights
Shear wave elastography (SWE) measures intestinal wall stiffness to predict the success of ultrasound-guided saline enema (USGSE) reduction for intussusception. Increased stiffness correlates with longer intussusception length, aiding clinical management decisions.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Surgical Innovation
Background:
- Intussusception, a common pediatric surgical emergency, involves intestinal telescoping.
- Ultrasound-guided saline enema (USGSE) is a primary reduction method for stable children.
- Predicting USGSE success is crucial for optimal patient management.
Purpose of the Study:
- To assess intestinal wall elasticity using shear wave elastography (SWE).
- To determine if SWE can predict the success of ultrasound-guided saline enema (USGSE) reduction for intussusception.
Main Methods:
- Ileocecal intussusception diagnosed via ultrasound (US).
- USGSE performed when not contraindicated.
- Intussusception length, diameter, and median intestinal stiffness (kPa) measured by SWE before reduction.
Main Results:
- 15 pediatric patients with ileocolic intussusception included.
- No significant age-stiffness correlation (P > 0.05).
- Moderate positive correlation between stiffness and intussusception length (r=0.547, P=0.035).
- No significant stiffness-diameter relationship (P > 0.05).
Conclusions:
- Intestinal wall stiffness measured by SWE is a potential new criterion for predicting USGSE success.
- SWE may aid clinical decision-making in managing ileocolic intussusception.
- SWE integration into US examinations offers enhanced diagnostic capabilities.
Background:
Intussusception is the invagination of the proximal intestinal segment into the distal portion. Reduction procedures with fluid or air have been used as the primary treatment of choice in clinically stable children.
Purpose:
To evaluate the role of intestinal wall elasticity measurements by shear wave elastography (SWE) to predict the success of ultrasound-guided saline enema (USGSE) reduction.
Methods:
USGSE was performed, if not contraindicated otherwise, after the diagnosis of ileocecal intussusception via the ultrasound (US). The length and diameter of the intussusception and the median stiffness of the intestine were measured before USGSE.
Results:
Seventeen children were diagnosed with ileocolic intussusception via grayscale US assessment. Two children whose SWE images became artifacts due to inadaptability were excluded from the study. Thus, the study involved 15 patients (9 boys, 6 girls; age range = 11-48 months). There was no statistically significant association between age and median stiffness measurement in kilopascal (kPa). (P > 0.05). A moderate positive correlation was observed between the median stiffness measurement (kPa) and the length of intussusception (r = 0.547; P = 0.035). There was no statistically significant relationship between median stiffness measurement (kPa) and short-axis diameter of intussusception (P > 0.05).
Conclusions:
Stiffness assessment of the intestinal wall in ileocolic intussusception during the US examination, which is the gold standard in the intussusception assessment, can be used as a new criterion for predicting the performance of the USGSE technique and might be useful in making decisions regarding the clinical management of ileocolic intussusception.
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