The value of saline-aided ultrasound in diagnosing congenital duodenal obstruction
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ORIGINAL ARTICLE
The value of saline‑aided ultrasound in diagnosing congenital duodenal obstruction Boyang Yang1 · Danping Huang1 · Luyao Zhou2 · Wei Zhong3 · Qiuming He3 · Zhe Wang3 · Qian Fang1 · Hongying Wang1 Accepted: 18 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The aim of the study is to assess the value of saline-aided ultrasound (US) in diagnosing congenital duodenal obstruction (CDO). Methods The neonates with CDO were enrolled in this study, including the neonates confirmed with annular pancreas (AP) by operation, the neonates confirmed with duodenal atresia, the neonates confirmed with duodenum web, and the neonates confirmed with malrotation. Pertinent data were recorded, including the US features, intraoperative findings, and surgical procedures. The methodology of this study is a diagnostic test study which means the US feature is the test and the intraoperative finding is the gold standard. Results A total of 95 neonates were enrolled, including 33 neonates with AP, 6 neonates with duodenal atresia, 29 neonates with duodenum web, and 27 neonates with malrotation. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the hyperechogenic band for the detection of AP were 78.8% (26/33), 90.3% (56/62), 81.2% (26/32), 88.8% (56/63), and 86.3% (82/95), respectively. The sensitivity, specificity, NPV, and accuracy for the detection of duodenal atresia were 0% (0/6), 100% (89/89), 93.6% (89/95), and 93.6% (89/95), respectively. The sensitivity, specificity, PPV, NPV, and accuracy for the detection of duodenum web were 100% (29/29), 100% (66/66), 100% (29/29), 100% (66/66), and 100% (95/95), respectively. The sensitivity, specificity, PPV, NPV, and accuracy for the detection of malrotation were 100% (27/27), 100% (68/68), 100% (27/27), 100% (68/68), and 100% (95/95), respectively. Conclusion Saline-aided US is a feasible tool to diagnose CDO. Keywords Neonate · Congenital duodenal obstruction · Ultrasound Abbreviations US Ultrasound CDO Congenital duodenal obstruction PPV Positive predictive value NPV Negative predictive value
* Hongying Wang [email protected] 1
Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, No. 9 of Jin Sui Road, Guangzhou 510623, China
2
Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
3
Department of Neonatal Surgery and Neonatal Surgical Intensive Care Unit, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510623, China
GI Gastrointestinal ST Stomach DD Dilated proximal duodenum SD Stenotic descending duodenum CD Collapsed distal duodenum P Pancreas AP Annular pancreas LIV Liver RK Right kidney SPINE Spine AO Abdominal aorta SMV Superior mesenteric vein SMA Superior mesenteric artery
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