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Published on: June 21, 2024
Agreement between sonographic and pathoanatomic classifications of pediatric urachal remnants
Laura S Oerters1, Sophie H K Maasewerd2, Mark Born3
1Sektion Kinderchirurgie der Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn,Germany.
Insights
Ultrasound accurately identifies urachal anomaly types for conservative management. This study found good agreement between ultrasound and surgical pathology, supporting its use in pediatric cases.
Area of Science:
- Pediatric Surgery
- Diagnostic Imaging
- Urology
Background:
- Ultrasound is preferred for monitoring urachal remnants during conservative management.
- The effectiveness of conservative treatment relies on accurate urachal anomaly typing.
- The diagnostic concordance between ultrasound and pathological findings requires assessment.
Purpose of the Study:
- To evaluate the agreement between sonographic and pathoanatomic diagnoses of urachal anomalies.
- To assess the accuracy of ultrasound in determining urachal anomaly types for conservative management.
Main Methods:
- Retrospective analysis of pediatric patients treated for urachal anomalies at two German centers (2008-2020).
- Comparison of ultrasound findings by specialized pediatric radiologists with post-resection pathoanatomic reports.
- Assessment of diagnostic agreement using crude agreement and Cohen's kappa coefficient.
Main Results:
- The study included 15 pediatric patients with a median age of 0.2 years.
- A crude agreement of 70% was observed between ultrasound and pathoanatomic diagnoses.
- Cohen's kappa coefficient was 0.66 (95% CI: 0.3-1, p <0.001), indicating substantial agreement.
Conclusions:
- Ultrasound demonstrated sufficient accuracy in identifying urachal anomaly types within this patient cohort.
- Findings suggest ultrasound is a reliable tool for guiding conservative management of urachal anomalies.
- Further validation with a larger study population is recommended to corroborate these results.
Aim:
Ultrasound is the favorite method for follow-up of urachal remnants when conservative management is chosen instead of surgical resection. However, the success of conservative management depends on the type of urachal anomaly, and the agreement between sonographic and pathoanatomic diagnoses has not yet been assessed.
Material And Methods:
We retrospectively included all minors treated for a urachal anomaly at two German pediatric surgical centers between January 2008 and December 2020. Ultrasound examinations were conducted by specialized pediatric radiologists and compared with pathoanatomic reports following resection of the urachal anomaly, with respect to its type.
Results:
We included 15 patients with a median age of 0.2 years. The crude agreement between ultrasound and pathoanatomic diagnosis was 70%, and Cohen's κ was 0.66 (95% confidence interval: 0.3 - 1, z = 3.83, p <0.001).
Conclusions:
Ultrasound identified the type of urachal anomaly with sufficient accuracy in this cohort; however, these findings should be corroborated by a substantially larger study.
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