Intussusception ultrasound: Difference between revisions
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[[File:Intussusception- Transverse view on Ultrasound 2.jpg|thumb|300x300px|Intussusception on transverse view on ultrasound. Source:Case courtesy of Dr Eric F Greif, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/29373">rID: 29373</a> |none]] | [[File:Intussusception- Transverse view on Ultrasound 2.jpg|thumb|300x300px|Intussusception on transverse view on ultrasound. Source:Case courtesy of Dr Eric F Greif, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/29373">rID: 29373</a> |none]] | ||
[[File:Intussusception- Longitudinal view.jpg|thumb|300x300px|Intussusception - longitudinal view on ultrasound Source:Case courtesy of Dr Eric F Greif, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/29373">rID: 29373</a> |none]] | [[File:Intussusception- Longitudinal view.jpg|thumb|300x300px|Intussusception - longitudinal view on ultrasound Source:Case courtesy of Dr Eric F Greif, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/29373">rID: 29373</a> |none]] | ||
[[File:Intussusception- Pseudokidney sign.jpg|none|thumb|300x300px|Pseudo - kidney sign seen on ultrasound | |||
Source:Case courtesy of Dr Ali Basim, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/49591">rID: 49591</a> | |||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 19:55, 18 December 2017
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Intussusception Microchapters |
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Intussusception On the Web |
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American Roentgen Ray Society Images of Intussusception |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
An x-ray may be helpful in the diagnosis of Intussusception. Findings on an x-ray suggestive of/diagnostic of Intussusception include target sign or doughnut sign and pseudokidney sign.
Ultrasound
- Ultrasound is the gold standard imaging modality used to diagnose Intussusception.[1]
- If the ultrasonographer is experienced then [2]
- Sensitivity - 100%
- Specificity - 100%
- Negative predictive value - 100%
- Target or doughnut sign[3]
- Edematous intussuscipiens forms an external ring around the centrally located intussusceptum.
- Target sign is usually seen in right lower quadrant.
- Layers of intussusception forms pseudo-kidney appearance on the transverse view.
- Ultrasound in adults.
- Less accurate than in children.
- Target sign or doughnut sign
- Concentric alternating echogenic and hypoechogenic bands.
- Echogenic bands are formed by mucosa and muscularis .
- Hypoechoic bands - formed by the submucosa.
- Can be visualized in transverse view.
- Pseudo-kidney sign
- It can be visualized in longitudinal view.
- The intussuscepted segment of bowel mimics a kidney.
- Ultrasound can be used to diagnose ileo-ileal intussusception which is a rare form. Fluoroscopy can miss this form of intussusception.
- Ultrasound can detect the pathology in 2/3rd number of cases.[4]
- Color duplex can detect ischemia of intussusception. It detects lack of perfusion.
- Small bowel intussusception
- Jejuno-jejunal or jejuno-ileal, rather than ileocolic intussusception -
- If the intussusception is outside of the right lower quadrant - paraumbilical or left abdominal region
- Lesion size ≤3 cm
- In children If small bowel intussusception is suspected and the symptoms are mild.
- Repeat the ultrasound to see if the finding persists as small bowel intussusceptions mostly reduce spontaneously.
- If the finding persist then next step is to evaluate using a CT scan. CT scan can detect if there is a lead point.
- The length of the intussusceptum is measured using ultrasound or CT. It helps to determine the prognosis so that management is started accordingly.
- Jejuno-jejunal or jejuno-ileal, rather than ileocolic intussusception -
- Limitations of ultrasound.[5]
- In cases of bowel distension and morbid obesity, massive air can result in reduced rate of detection and diagnosis of intussusception.
References
- ↑ Ko HS, Schenk JP, Tröger J, Rohrschneider WK (2007). "Current radiological management of intussusception in children". Eur Radiol. 17 (9): 2411–21. doi:10.1007/s00330-007-0589-y. PMID 17308922.
- ↑ Hryhorczuk AL, Strouse PJ (2009). "Validation of US as a first-line diagnostic test for assessment of pediatric ileocolic intussusception". Pediatr Radiol. 39 (10): 1075–9. doi:10.1007/s00247-009-1353-z. PMID 19657636.
- ↑ Boyle MJ, Arkell LJ, Williams JT (1993). "Ultrasonic diagnosis of adult intussusception". Am. J. Gastroenterol. 88 (4): 617–8. PMID 8470658.
- ↑ Navarro O, Dugougeat F, Kornecki A, Shuckett B, Alton DJ, Daneman A (2000). "The impact of imaging in the management of intussusception owing to pathologic lead points in children. A review of 43 cases". Pediatr Radiol. 30 (9): 594–603. doi:10.1007/s002470000261. PMID 11009295.
- ↑ Mrak K (2014). "Uncommon conditions in surgical oncology: acute abdomen caused by ileocolic intussusception". J Gastrointest Oncol. 5 (4): E75–9. doi:10.3978/j.issn.2078-6891.2014.044. PMC 4110501. PMID 25083311.