Advertisement

Diagnostic performance of ultrasound without any colon preparation for detecting colorectal polyps in pediatric patients

  • Takahiro HosokawaEmail author
  • Mayumi Hosokawa
  • Yutaka Tanami
  • Yumiko Sato
  • Ryosuke Nambu
  • Itaru Iwama
  • Eiji Oguma
  • Yoshitake YamadaEmail author
Original Article

Abstract

Background

There are limited data on the sensitivity, specificity and accuracy of ultrasound for detecting colorectal polyps in children and young adults.

Objective

To evaluate the diagnostic accuracy of ultrasound, without any colon preparation, for detecting colorectal polyps in pediatric patients and to determine the causes of false-negative results.

Materials and methods

We included 74 children with clinical signs like rectal bleeding, abdominal pain or diarrhea who underwent both ultrasound and colonoscopy. We evaluated the diagnostic performance of ultrasound for detecting colorectal polyps before colonoscopy, which served as the reference standard. We used Fisher exact and Student’s t-tests for statistical analyses.

Results

Fifteen pediatric patients were diagnosed with colorectal polyps in the transverse (n=3), descending (n=1) and sigmoid (n=6) colon, and rectum (n=5) by colonoscopy. The sensitivity, specificity and accuracy of ultrasound to detect colorectal polyps were 47% (7/15, 95% confidence interval [CI] 21–73%), 100% (59/59, 95% CI 94–100%) and 89% (66/74, 95% CI 80–95%), respectively. The volume (mean ± standard deviation) of polyps not detected by ultrasound was significantly smaller than that detected (270±380 mm3 vs. 4,600±3,900 mm3, P=0.0124). We observed a significant difference in the location between the polyps detected and not detected by ultrasound (rectal/non-rectal=0/7 vs. 5/3, P=0.0256). No significant age or gender difference was observed.

Conclusion

The accuracy for detecting colorectal polyps by ultrasound was 89% (95% CI, 80–95%) in our cohort. Polyps found in the rectum and relatively smaller polyps accounted for several false-negative cases.

Keywords

Children Colon Colonoscopy Juvenile polyp Screening Sonography Ultrasound 

Notes

Compliance with ethical standards

Conflicts of interest

None

References

  1. 1.
    Pillai RB, Tolia V (1998) Colonic polyps in children: frequently multiple and recurrent. Clin Pediatr 37:253–257CrossRefGoogle Scholar
  2. 2.
    Corredor J, Wambach J, Barnard J (2001) Gastrointestinal polyps in children: advances in molecular genetics, diagnosis, and management. J Pediatr 138:621–628CrossRefGoogle Scholar
  3. 3.
    Jelsig AM, Ousager LB, Brusgaard K, Qvist N (2016) Juvenile polyps in Denmark from 1995 to 2014. Dis Colon Rectum 59:751–757CrossRefGoogle Scholar
  4. 4.
    Uchiyama M, Iwafuchi M, Yagi M et al (2001) Fiberoptic colonoscopic polypectomy in childhood: report and review of cases. Pediatr Int 43:259–262CrossRefGoogle Scholar
  5. 5.
    Baldisserotto M, Spolidoro JV, Bahu Mda G (2002) Graded compression sonography of the colon in the diagnosis of polyps in pediatric patients. AJR Am J Roentgenol 179:201–205CrossRefGoogle Scholar
  6. 6.
    Hunter A, Mamula P (2010) Bowel preparation for pediatric colonoscopy procedures. J Pediatr Gastroenterol Nutr 51:254–261Google Scholar
  7. 7.
    Karacaer F, Biricik E, Ilginel M et al (2018) Remifentanil-ketamine vs. propofol-ketamine for sedation in pediatric patients undergoing colonoscopy: a randomized clinical trial. Rev Bras Anestesiol 68:597–604CrossRefGoogle Scholar
  8. 8.
    Lee J, Park SW, Kim YS et al (2017) Risk factors of missed colorectal lesions after colonoscopy. Medicine 96:e7468CrossRefGoogle Scholar
  9. 9.
    Parra DA, Navarro OM (2008) Sonographic diagnosis of intestinal polyps in children. Pediatr Radiol 38:680–684CrossRefGoogle Scholar
  10. 10.
    Qu NN, Liu RH, Shi L et al (2018) Sonographic diagnosis of colorectal polyps in children: diagnostic accuracy and multi-factor combination evaluation. Medicine 97:e12562CrossRefGoogle Scholar
  11. 11.
    Tomizawa M, Shinozaki F, Hasegawa R et al (2015) Factors affecting the detection of colorectal cancer and colon polyps on screening abdominal ultrasonography. Hepatogastroenterology 62:295–298Google Scholar
  12. 12.
    Wei C, Dayong W, Liqun J et al (2012) Colorectal polyps in children: a retrospective study of clinical features and the value of ultrasonography in their diagnosis. J Pediatr Surg 47:1853–1858CrossRefGoogle Scholar
  13. 13.
    Park JH (2010) Role of colonoscopy in the diagnosis and treatment of pediatric lower gastrointestinal disorders. Korean J Pediatr 53:824–829CrossRefGoogle Scholar
  14. 14.
    Yoshioka S, Takedatsu H, Fukunaga S et al (2017) Study to determine guidelines for pediatric colonoscopy. World J Gastroenterol 23:5773–5779CrossRefGoogle Scholar
  15. 15.
    Gupta SK, Fitzgerald JF, Croffie JM et al (2001) Experience with juvenile polyps in North American children: the need for pancolonoscopy. Am J Gastroenterol 96:1695–1697Google Scholar
  16. 16.
    Nagita A, Amemoto K, Yoden A et al (1994) Ultrasonographic diagnosis of juvenile colonic polyps. J Pediatr 124:535–540CrossRefGoogle Scholar
  17. 17.
    Koppen IJ, Yacob D, Di Lorenzo C et al (2017) Assessing colonic anatomy normal values based on air contrast enemas in children younger than 6 years. Pediatr Radiol 47:306–312CrossRefGoogle Scholar
  18. 18.
    Mirjalili SA, Tarr G, Stringer MD (2017) The length of the large intestine in children determined by computed tomography scan. Clin Anat 30:887–893CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of RadiologySaitama Children’s Medical CenterSaitamaJapan
  2. 2.Department of PediatricsSaitama City HospitalSaitamaJapan
  3. 3.Division of Gastroenterology and HepatologySaitama Children’s Medical CenterSaitamaJapan
  4. 4.Department of RadiologyKeio University School of MedicineTokyoJapan

Personalised recommendations