[Imaging of anorectal malformations in the neonatal period].
OBJECTIVE
The classification of anorectal malformations (ARM) as high or low is based on clinical and anatomical characteristics. It has an impact on the surgical management but also on the functional prognosis. In the absence of consensus, our goal was to determine the value of imaging in the neonatal period for diagnosis and management of infants with ARM.


METHODS
Retrospective study of 43 infants imaged over a 9 year period. The different imaging studies (abdominal and pelvic ultrasound, radiographs, percutaneous opacifications and fistulograms) performed for each infant were collected and analyzed then correlated to clinical and surgical findings.


RESULTS
Clinical evaluation could classify 30 ARM as low and 4 ARM as high while 9 ARM without fistula remained indeterminate. Imaging findings were mixed: on ultrasound, the rectal cul-de-sac to perineum distance did not appear to be determinant, contrary to published data. Pelvimetry showed limitations, irrespective of the technique. Morphological evaluation provided the following data: presence of fistula, sphincter anatomy, rectal cul-de-sac to perineum distance.


CONCLUSIONS
Classification relies on clinical evaluation in most cases. Opacification techniques and ultrasound remain useful in some cases. MRI could become the preferred imaging modality.
Le Bayon
A G
AG
Service de Radiologie pédiatrique, Hôpital Clocheville, CHU Tours, 37000 Tours. annegwentours@yahoo.fr
Carpentier
E
E
Boscq
M
M
Lardy
H
H
Sirinelli
D
D
D001003:Anal Canal / Q000002:abnormalities* / Q000000981:diagnostic imaging; D001006:Anus, Imperforate / Q000000981:diagnostic imaging; D002988:Cloaca / Q000002:abnormalities; D003287:Contrast Media; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010502:Perineum / Q000002:abnormalities; D011859:Radiography; D012003:Rectal Fistula / Q000151:congenital; D012007:Rectum / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014463:Ultrasonography; D014522:Urethral Diseases / Q000151:congenital; D001747:Urinary Bladder Fistula / Q000151:congenital; D014548:Urinary Fistula / Q000151:congenital; D014719:Vesicovaginal Fistula / Q000151:congenital
D003287:Contrast Media