DIAGNOSTIC VALUE OF CONTRAST ENEMA IN HIRSCHSPRUNG’S DISEASE IN CHILDREN
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Abstract
Background: Hirschsprung’s disease is one of the most common causes relates to gastrointestinal operation in children in Vietnam. Contrast enema is the first choice of the imaging modality to diagnose HD, with signs: Narrow distal colon, dilated proximal colon, and a transition zone. Objectives: Determining the value of radiologic findings for the HD diagnosis in children who underwent contrast enema. Materials and methods: A Cross-sectional study from the children suspected HD at Children’s Hospital 2 with contrast enema, normal anus, and pathology result. Results: A total of 73 patients were included (mode age 2 months; 65.7% male). 41/73 patients with HD (mode age 3 months, 78% male). Sensitivity, specificity, PPV, NPV and accuracy were 78%, 68.8%, 76.2%, 71%, and 74% respectively for contrast enema transition zone (CETZ). Sensitivity, specificity, PPV, NPV, and accuracy were 90%, 59.4%, 71.1%, 81%, and 74% respectively for rectosigmoid index <1. Sensitivity, specificity were 24.4%, 87.5% respectively for irregular contraction. Sensitivity and specificity were 34.1%, 71.9% respectively for irregular mucosal. Sensitivity and specificity were 75.6%, 21.9% respectively for mixed appearance. The accuracy of CETZ to determine the level of aganglionosis was 81.5%. Specificity and PPV were 78.1%, 81.1% respectively for high grade (5-8 points). Conclusions: Contrast enema is a high-value tool for HD diagnosis. Using a radiology scoring system for HD diagnosis can increase the sensitivity and PPV value.
Keywords
megacolon, Hirschsprung’s disease, contrast enema, rectosigmoid index, RSI, aglanglionosis
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