Use of Ultrasound in the Diagnostic Work-Up of Adult Intussusception – A Multicenter Retrospective Analysis.

Autor: Klinger, Christoph; Riecken, Bettina; Dietrich, Christoph Frank; Dirks, Klaus; Caca, Karel; Fröhlich, Eckhart

Publication year: 2020

Ultraschall in der Medizin (Stuttgart, Germany : 1980)

issn:1438-8782 0172-4614

doi: 10.1055/a-0604-2676

Abstract:

PURPOSE: To evaluate the use of ultrasound (US) in the diagnostic work-up of adult intussusception (AI). METHODS: This multicenter study includes 26 consecutive patients diagnosed with AI between January 2010 and November 2017. A retrospective chart analysis was conducted with a focus on abdominal US findings and diagnostic accuracy of different imaging modalities (ultrasound, computed tomography (CT), magnetic resonance imaging). If available, surgical and pathological findings served as the gold standard (76.9 %). US examiners certified according to DEGUM grade 2 or 3 were classified as experts. Otherwise, they were regarded to have basic skills. RESULTS: During diagnostic work-up, 92.3 % underwent abdominal US. US was the first-line imaging modality in 88.5 % of cases. The accuracy regarding the detection of AI (85 %), correct localization (95 %) and detection of complications (100 %) was excellent and comparable with CT (81 %, 90.5 %, and 91.7 %) when performed by experts. 72.7 % of tumorous lead points were detected by experienced examiners. In contrast, AI was detected in only 45.5 % of cases by examiners with basic skills. AI was diagnosed prior to surgery in all patients. CONCLUSION: US is reliable in the diagnostic work-up of AI when performed by experienced examiners with high-quality equipment. US, CT and MRI should be used in a complementary fashion since combination provides excellent sensitivity regarding the detection and correct localization of AI as well as the detection of complications. The impact of real-time imaging is illustrated by supplementary videos.

Language: eng

Pmid: 29975971

Tags: Humans; Sensitivity and Specificity; Adult; Retrospective Studies; Magnetic Resonance Imaging; Tomography, X-Ray Computed; *Ultrasonography; *Intussusception/diagnostic imaging

Link: https://pubmed.ncbi.nlm.nih.gov/29975971/