Is color Doppler a reliable method for the diagnosis of malrotation?

J Med Ultrason (2001). 2018 Jan;45(1):59-64. doi: 10.1007/s10396-017-0794-5. Epub 2017 May 25.

Abstract

Purpose: The gold standard for the diagnosis of malrotation is barium contrast study of the upper gastrointestinal system (UGCS), while color Doppler ultrasonography (CDUS) is another method used in the diagnosis. We investigated the value of CDUS for the diagnosis of malrotation in this study.

Methods: UGCS images, CDUS images, plain abdominal images, demographic data, and symptoms of 82 patients who were investigated for presumed malrotation during a 7-year period were evaluated, retrospectively.

Results: All patients underwent CDUS, and 18% of these patients were diagnosed with malrotation as the superior mesenteric vein was seen to be on the left of the superior mesenteric artery. We found that 16% of the 75 patients who underwent UGCS were diagnosed with malrotation. The sensitivity and specificity of CDUS in the diagnosis of malrotation was found to be 93.8 and 100%, respectively. The respective values for UGCS were 91.7 and 98.4%.

Conclusion: Current data in the literature and our results underline that UGCS may yield false-positive and false-negative results. Although CDUS was found to be a reliable method for the diagnosis of malrotation in our study, the limitations of UGCS are also recognized for CDUS. Prospective studies are needed to determine the more valuable method.

Keywords: Color Doppler ultrasonography; Malrotation; Nonrotation; Upper gastrointestinal series.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Digestive System Abnormalities / diagnosis
  • Digestive System Abnormalities / diagnostic imaging*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intestinal Volvulus / diagnosis
  • Intestinal Volvulus / diagnostic imaging
  • Male
  • Mesenteric Artery, Superior / abnormalities
  • Mesenteric Artery, Superior / diagnostic imaging*
  • Mesenteric Veins / abnormalities
  • Mesenteric Veins / diagnostic imaging*
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Ultrasonography, Doppler, Color*

Supplementary concepts

  • Volvulus Of Midgut