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Ultrasound as a screening study for gastro-oesophageal reflux in children
S Wynchank1, M D Mann, R Fisher
1Department of Nuclear Medicine, Red Cross War Memorial Children's Hospital, Rondebosch, South Africa. SWYNCHAN@EAGLE.MRC.AC.ZA
Insights
Ultrasound is a highly effective initial diagnostic tool for detecting gastro-oesophageal reflux in children. This study found ultrasound comparable to scintigraphy, recommending its increased use in pediatric diagnostics.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Medical Technology Assessment
Background:
- Gastro-oesophageal reflux is a common condition in children, requiring accurate diagnostic methods.
- Both ultrasound and scintigraphy are used to evaluate pediatric gastro-oesophageal reflux.
- Comparing the diagnostic efficacy of these modalities is crucial for optimizing clinical practice.
Purpose of the Study:
- To compare the diagnostic accuracy of ultrasound and scintigraphy in detecting gastro-oesophageal reflux in pediatric patients.
- To evaluate the impact of the time interval between scintigraphy and ultrasound on diagnostic concordance.
- To determine the most effective initial investigation for suspected pathological reflux in children.
Main Methods:
- A comparative study involving 110 children (mean age 24.5 months) with suspected gastro-oesophageal reflux.
- Group A (n=49) underwent scintigraphy followed by ultrasound within 30 minutes.
- Group B (n=61) underwent scintigraphy followed by ultrasound between 1 and 30 days later.
Main Results:
- High concordance (91/110 patients) was observed between ultrasound and scintigraphy findings.
- Discordant results (19/110 patients) were explained by plausible underlying mechanisms.
- Ultrasound demonstrated significant utility in identifying gastro-oesophageal reflux.
Conclusions:
- Ultrasound is a reliable and effective imaging technique for diagnosing gastro-oesophageal reflux in children.
- The study supports the increased utilization of ultrasound as a first-line investigation for suspected pathological reflux.
- Ultrasound offers a valuable, potentially more frequent, initial diagnostic approach in pediatric reflux evaluation.
Abstract:
A comparison of the abilities of ultrasound and scintigraphy to detect gastro-oesophageal reflux was made in 110 children (mean age 24.5 months) who were divided into groups A (n = 49) and B (n = 61). The former had scintigraphy first followed by ultrasound within about 30 min. For group B scintigraphy was also performed first, but the delay before ultrasound ranged between 1 and 30 days. In most patients (91/110) concordant results were obtained by the two modalities. The 19/110 discordant results can be explained by several plausible mechanisms. It is concluded that ultrasound should be employed much more frequently as an initial investigation when pathological reflux is suspected in children.