[Sonographic visualization of the axial level of the anal sphincters. Preliminary results in children].
BACKGROUND
The sonographic visualization of anal sphincter structures in children through perineal sections in the sagittal and the coronary plane is unsatisfactory for the assessment of morphologic pathologies. Only the scan direction vertically to the longitudinal axis of the rectum facilitates the showing of the sphincter structures and their circumferential course. Up to now, this could only be achieved by a rectal introduction of the probe. This method has not found any acceptance with the diagnosis of children due to the necessary penetration as well as problems with orientation, resolution and time consuming preparations.


METHODS
The anal sphincter structures of 10 children in the age of 2-6 years were examined. As a control group 5 children had no previous operations and a normal bowel movement. The others had previous operations due to anal atresia as well as pathological defecation. The Combison 530D (Kretz) was used. We started with the prototype of a 3D transducer that was derived from those designed for intravaginal use in gynecology. Modifications were made concerning the transducer design, the direction of the ultrasound was changed to 145 degrees forward angulation and a probe with short focus and 7.5 MHz.


RESULTS
Our first investigations showed that axial levels calculated from the digitally registered volume scan permit so far not yet achieved visualization of the anal sphincter structures in children. Relevant pathomorphological findings can exactly be located. The examinations are non invasive and well accepted by children.
Pistor
G
G
Kinderklinik/Kinderchirurgie, Städtisches Klinikum Brandenburg a.d. Havel/Akademisches Lehrkrankenhaus der Humboldt-Universität, Berlin. Gert.Pistor@t-online.de
D001003:Anal Canal / Q000000981:diagnostic imaging*; D001004:Anus Diseases / Q000000981:diagnostic imaging; D001006:Anus, Imperforate / Q000000981:diagnostic imaging* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007091:Image Processing, Computer-Assisted; D012016:Reference Values; D014463:Ultrasonography