The impact of preoperative ultrasound on correct diagnosis of urachal remnants in children.
BACKGROUND
Ultrasound is a noninvasive imaging method used widely in urachal diagnostics. This study investigated the effectiveness of ultrasonography in correctly depicting urachal anomalies in children.


METHODS
Preoperative ultrasound findings of all patients who were operated on for suspected urachal anomalies between 1990 and 2008 were retrospectively compared with the final diagnosis.


RESULTS
Fifty-three patients (31 female, 22 male; approximately 2.6 years; range, 0-17 years) were reviewed. In 37 patients, the final diagnosis of an urachal anomaly matched the ultrasound findings. In 7 patients, there was a false-positive ultrasound finding, and in 9 patients, there was a false-negative ultrasound finding. Three of 4 patients with urachal cysts, 23 of 29 patients with urachal fistulas, and 8 of 10 patients with urachal sinuses were correctly identified by ultrasonography. In 10 patients, no urachal rests were found intraoperatively: in 7 of these patients, urachal rests were falsely suspected by ultrasound. The positive predictive value for ultrasound is 83%, whereas the negative predictive value is 25%. The sensitivity for this diagnostic method is 79% and the specificity 30%.


CONCLUSIONS
Ultrasound helps to identify urachal anomalies in case of their presence but is not helpful to rule out a nonexisting urachal anomaly.
Widni
Eva E
EE
Department of Paediatric and Adolescent Surgery, Medical University of Graz, 3036 Graz, Austria.
Höllwarth
Michael E
ME
Haxhija
Emir Q
EQ
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014496:Urachal Cyst / Q000000981:diagnostic imaging / Q000601:surgery; D014497:Urachus / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000601:surgery