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Intramural and subserosal echogenic foci on US in large-bowel intussusceptions: prognostic indicator for reducibility?

Stranzinger, Enno ; DiPietro, Michael ; Yarram, Sai ; Khalatbari, Shokoufeh ; Strouse, Peter

In: Pediatric Radiology, 2009, vol. 39, no. 1, p. 42-46

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    Titre
    • Intramural and subserosal echogenic foci on US in large-bowel intussusceptions: prognostic indicator for reducibility?
    Auteur
    • Stranzinger, Enno. Department of Diagnostic Radiology, Inselspital Berne (University Hospital of Berne), CH-3010, Berne, Switzerland
    • DiPietro, Michael. Section of Pediatric Radiology, University of Michigan Health System, Ann Arbor, MI, USA
    • Yarram, Sai. Section of Pediatric Radiology, University of Michigan Health System, Ann Arbor, MI, USA
    • Khalatbari, Shokoufeh. Michigan Institute for Clinical and Health Research (MIHR), Ann Arbor, MI, USA
    • Strouse, Peter. Section of Pediatric Radiology, University of Michigan Health System, Ann Arbor, MI, USA
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:315628
    Summary
    Background: In large-bowel intussusceptions, several US signs are known to indicate a lower likelihood of reducibility by enema. US can demonstrate echogenic dots or lines (foci) in the bowel wall, which might indicate an ischemic bowel. Objective: To determine the presence of echogenic intramural and subserosal foci in large-bowel intussusceptions and to evaluate the degree of correlation with reducibility. Materials and methods: Between 2001 and 2008, 74 consecutive US examinations were retrospectively evaluated by two pediatric radiologists for intramural and subserosal echogenic foci, or trapped gas, in the intussusception. The degree of correlation between the sonographic findings and reducibility was evaluated. Results: Of 73 intussusceptions examined by US, 56 (76%) were reducible and 17 (23%) were not reducible. Out of 10 intussusceptions with intramural gas, 11 with subserosal gas, and 14 with intramural and subserosal gas, 8 (80%), 6 (56%), 9 (64%), respectively, were not reducible. The presence of intramural gas or subserosal gas or both predicted a lower chance of reduction, but with regard to the effect of these findings together, intramural gas was the only significant predictor. Conclusion: Having intramural gas in large-bowel intussusception significantly decreases the chance of reduction