Journal of pediatric surgery · 2010
The impact of preoperative ultrasound on correct diagnosis of urachal remnants in children.
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Widni Eva E, Höllwarth Michael E, Haxhija Emir Q
Аннотация
BACKGROUND: Ultrasound is a noninvasive imaging method used widely in urachal diagnostics. This study investigated the effectiveness of ultrasonography in correctly depicting urachal anomalies in children.
METHODS: Preoperative ultrasound findings of all patients who were operated on for suspected urachal anomalies between 1990 and 2008 were retrospectively compared with the final diagnosis.
RESULTS: Fifty-three patients (31 female, 22 male; approximately 2.6 years; range, 0-17 years) were reviewed. In 37 patients, the final diagnosis of an urachal anomaly matched the ultrasound findings. In 7 patients, there was a false-positive ultrasound finding, and in 9 patients, there was a false-negative ultrasound finding. Three of 4 patients with urachal cysts, 23 of 29 patients with urachal fistulas, and 8 of 10 patients with urachal sinuses were correctly identified by ultrasonography. In 10 patients, no urachal rests were found intraoperatively: in 7 of these patients, urachal rests were falsely suspected by ultrasound. The positive predictive value for ultrasound is 83%, whereas the negative predictive value is 25%. The sensitivity for this diagnostic method is 79% and the specificity 30%.
CONCLUSIONS: Ultrasound helps to identify urachal anomalies in case of their presence but is not helpful to rule out a nonexisting urachal anomaly.
METHODS: Preoperative ultrasound findings of all patients who were operated on for suspected urachal anomalies between 1990 and 2008 were retrospectively compared with the final diagnosis.
RESULTS: Fifty-three patients (31 female, 22 male; approximately 2.6 years; range, 0-17 years) were reviewed. In 37 patients, the final diagnosis of an urachal anomaly matched the ultrasound findings. In 7 patients, there was a false-positive ultrasound finding, and in 9 patients, there was a false-negative ultrasound finding. Three of 4 patients with urachal cysts, 23 of 29 patients with urachal fistulas, and 8 of 10 patients with urachal sinuses were correctly identified by ultrasonography. In 10 patients, no urachal rests were found intraoperatively: in 7 of these patients, urachal rests were falsely suspected by ultrasound. The positive predictive value for ultrasound is 83%, whereas the negative predictive value is 25%. The sensitivity for this diagnostic method is 79% and the specificity 30%.
CONCLUSIONS: Ultrasound helps to identify urachal anomalies in case of their presence but is not helpful to rule out a nonexisting urachal anomaly.