COntrast-enhanced COlonosonography in AnoRectal Malformations (CoCo-ARM) Study

Area of Science:

• Pediatric Surgery
• Diagnostic Imaging
• Radiology

Background:

• Fluoroscopic colostography (FC) is the standard for surgical planning in anorectal malformation (ARM).
• Contrast-enhanced colosonography (CeCS) presents a potential alternative imaging modality.
• This study prospectively compares CeCS accuracy against FC in male ARM patients.

Purpose of the Study:

• To compare the diagnostic accuracy of CeCS with FC.
• To evaluate CeCS's effectiveness in identifying fistular anatomy in ARM.
• To assess the confidence levels associated with CeCS reporting.

Main Methods:

• Prospective, single-centre study of 11 male ARM patients awaiting surgery.
• CeCS performed using SonoVue, reported contemporaneously by two radiologists.
• FC performed departmentally; both modalities reported by a third blinded radiologist using a Likert scale.

Main Results:

• Agreement between CeCS and FC in 73% of cases (8/11).
• CeCS identified fistulas missed or unclear on FC in 2 cases.
• 100% agreement between CeCS findings and operative results in surgically treated patients.

Conclusions:

• CeCS is equivalent or superior to FC for identifying fistular anatomy in male ARM.
• CeCS allows for high diagnostic confidence in reporting imaging studies.
• CeCS is a valuable tool for pre-surgical planning in ARM.