Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2024; 30(7): 705-713
Published online Feb 21, 2024. doi: 10.3748/wjg.v30.i7.705
Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children
Yu-Hua Zhang, Zhi-Hua Xu, Shuang-Shuang Ni, Hong-Xia Luo
Yu-Hua Zhang, Zhi-Hua Xu, Shuang-Shuang Ni, Hong-Xia Luo, Department of Ultrasound, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Author contributions: Zhang YH and Luo HX conception and design; Xu ZH and Ni SS provision of study materials or patients; Zhang YH and Xu ZH collection and assembly of data; Zhang YH and Luo HX data analysis and interpretation; All authors writing and final approval of manuscript. All the authors meet the authorship criteria and have read and approved the final version to be published.
Supported by Scientific Research Fund of the Wenzhou Science and Technology Division, No. Y2020798 and No. Y2020805.
Institutional review board statement: The study was reviewed and approved by the institutional review boards of The Second Affiliated Hospital of Wenzhou Medical University Research Ethics Committee (Approval No. LCKY2020-289).
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: The authors of this manuscript having no conflicts of interest to disclose.
Data sharing statement: There is no additional data available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Xia Luo, MD, Associate Chief Physician, Doctor, Department of Ultrasound, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West College Road, Wenzhou 325000, Zhejiang Province, China. luohongxia0127@163.com
Received: August 25, 2023
Peer-review started: August 25, 2023
First decision: November 20, 2023
Revised: December 18, 2023
Accepted: January 23, 2024
Article in press: January 23, 2024
Published online: February 21, 2024
Abstract
BACKGROUND

The detection rate of peptic ulcer in children is improving, with development of diagnostic procedures. Gastroscopy is the gold standard for the diagnosis of peptic ulcer, but it is an invasive procedure. Gastrointestinal contrast-enhanced ultrasonography (CEUS) has the advantages of being painless, noninvasive, nonradioactive, easy to use, and safe.

AIM

To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children.

METHODS

We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022. All children were examined by routine ultrasound, gastrointestinal CEUS, and gastroscopy. The pathological results of gastroscopy were taken as the gold standard. Routine ultrasonography was performed before gastrointestinal CEUS. Conventional ultrasound showed the thickness of the gastroduodenal wall, gastric peristalsis, and the adjacent organs and tissues around the abdominal cavity. Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall; the size, location and shape of the ulcer; gastric peristalsis; and adjacent organs and tissues around the abdominal cavity. The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS. All children received informed consent from their guardians for CEUS. This study was reviewed and approved by the hospital medical ethics committee.

RESULTS

Among the 43 children, 17 (15 male, 2 female) were diagnosed with peptic ulcer by gastroscopy. There were 26 children with nonpeptic ulcer. There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound. The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1% (34/43), which was significantly different from that of gastroscopy (P = 0.033). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low. Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS. The diagnostic coincidence rate of peptic ulcer in children was 95.3% (41/43). There was no significant difference between CEUS and gastroscopy (P = 0.655). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high.

CONCLUSION

Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children, and can be used as a preliminary examination method.

Keywords: Contrast-enhanced ultrasound, Peptic ulcer, Children, Gastrointestinal tract, Abdominal pain, Acoustic contrast agent

Core Tip: In this study, routine gastrointestinal ultrasound and contrast-enhanced ultrasonography (CEUS) in children were compared with gastroscopy. The clinical coincidence rate between gastrointestinal CEUS and gastroscopy was higher, which provided a new examination method for pediatricians to screen upper gastrointestinal diseases. This method is painless, noninvasive, nonradioactive, simple to operate, accepted by children and parents, and can be used as a preliminary screening method for children with epigastric pain. It is expected to be an effective supplement to gastroscopy and provide a reference for clinical selection of appropriate treatment.