Anorectal malformation and contrast-enhanced ultrasonography

Area of Science:

• Pediatric Surgery
• Diagnostic Imaging
• Medical Technology

Background:

• Anorectal malformations (ARMs) are congenital anomalies requiring accurate diagnosis.
• Conventional imaging methods for ARMs may involve ionizing radiation.
• Minimally invasive diagnostic tools are sought for pediatric patients.

Purpose of the Study:

• To evaluate the utility of contrast-enhanced ultrasonography (CEUS) for diagnosing anorectal malformations.
• To assess the ability of CEUS to visualize and locate anorectal fistulas.

Main Methods:

• Five pediatric patients (13 days–22 months) with suspected fistulas underwent colosonography (contrast-enhanced ultrasound enema).
• A dedicated ultrasound system with contrast visualization software and second-generation ultrasound contrast agents were used.
• Results were correlated with contrast-enhanced radiology, colostograms, or enemas.

Main Results:

• Colosonography successfully visualized and located fistulous tracts in all evaluated cases.
• The rectal pouch-sacrum-coccyx relationship was assessed, and no presacral masses were detected.
• Associated urological malformations were identified in two patients.

Conclusions:

• Colosonography is a valuable real-time imaging modality for assessing anorectal malformations and fistulas.
• This technique accurately determines the presence, location, and tract of fistulas.
• CEUS offers a safe alternative to ionizing radiation, with no reported side effects.