Prenatal Evaluation for Detection of Anorectal Atresia: Value of Ultrasound
| Autor: | Yi-Ming Su, Jin-Rong Lin, Yan Lin, Guorong Lv, Hong-Yi Yang, Shuqiang Chen |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Anal Canal Rectum Prenatal diagnosis Ultrasonography Prenatal 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Pregnancy otorhinolaryngologic diseases medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Anorectal atresia Fetus 030219 obstetrics & reproductive medicine Radiological and Ultrasound Technology business.industry Ultrasound Reproducibility of Results Gestational age Anal canal medicine.disease Anorectal Malformations medicine.anatomical_structure Female Radiology Imperforate anus business |
| Zdroj: | Journal of Ultrasound in Medicine. 38:1501-1509 |
| ISSN: | 1550-9613 0278-4297 |
| DOI: | 10.1002/jum.14836 |
| Popis: | Objectives To investigate the applicability and value of ultrasound (US) in the diagnosis of anorectal atresia. Methods Between January 2008 and January 2016, we prospectively evaluated 63,101 fetuses (gestational age, 20-38 weeks), including low- and high-risk populations using 2-dimensional US scans. An abnormal imaging finding was defined as an anal canal diameter of less than the 95% confidence interval (small anal canal) of the normal range or the absence of an anal canal and rectum. Imaging findings were considered normal on detection of an anal canal with a normal width and the absence of abnormalities. Prenatal imaging findings were confirmed by a postnatal or postmortem examination. Results Among the investigated fetuses, 28 showed evidence of anorectal atresia on US scans, and 22 of those with anorectal atresia had additional anomalies. Six cases of isolated anorectal atresia were successfully detected during the preclusive prenatal US scans. Four cases of a low imperforate anus (including 2 covered anuses) yielded false-negative results, indicating a diagnostic rate of 87.5% (28 of 32). The normal appearance of the fetal rectum and anal canal ruled out anorectal atresia in 30 fetuses with a dilated colon. Additionally, there were 3 false-positive cases, in which a narrow anal canal was observed. Conclusions Identifying the abnormal appearance or absence of the fetal anal canal and rectum on preclusive US anomaly scans is useful for prenatal diagnosis or exclusion of anorectal atresia, which may help improve the detection of isolated anorectal atresia. Furthermore, a combined evaluation of the longitudinal and axial appearances of the fetal anal canal and rectum can improve diagnostic accuracy. |
| Databáze: | OpenAIRE |
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