Contrast-Enhanced Ultrasound in Children with Anorectal Malformations: A Radiation-Free Alternative to…

Cohort studyJournal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine· Aug 2026

Contrast-Enhanced Ultrasound in Children with Anorectal Malformations: A Radiation-Free Alternative to Fluoroscopy for Identifying Fistulae with Genitourinary Tract.

Hritika Rathi, Anmol Bhatia, Nitin James Peters … Akshay Kumar Saxena

Read paper

Pediatric SurgeryCohort studyDiagnosisQ2IF 2.5

Contrast ultrasound detected genitourinary fistulae in anorectal malformation with 100% sensitivity

Contrast-Enhanced Ultrasound in Children with Anorectal Malformations: A Radiation-Free Alternative to Fluoroscopy for Identifying Fistulae with Genitourinary Tract.

Hritika Rathi … Akshay Kumar Saxena

Journal of ultrasound in medicine · Aug 2026 · Q2 in General Medicine

Purpose

To explore the utility of contrast-enhanced ultrasono-distal cologram (contrast-enhanced ultrasono-distal cologram) as a radiation-free modality to detect fistulae with genitourinary tract in children with anorectal malformation (anorectal malformation), compared with fluoroscopic distal cologram (fluoroscopic distal cologram) as the gold standard.

Methods

In this IRB-approved prospective study, 50 children (up to 2 years of age) with ARMs were enrolled over an 18-month period (January 2024-June 2025).

n = 50 children

100%

Results

100%

contrast ultrasound missed no genitourinary fistula, matching fluoroscopy

n = 50 children

More results

Rectourethral, rectovesical, rectoperineal, and rectovaginal fistulas were seen in 27/50 (54%), 1/50 (2%), 11/50 (22%), and 4/50 (8%) children, respectively, on fluoroscopic distal cologram.

No fistula was seen in 7/50 (14%) children on fluoroscopic distal cologram.

More results

One fistula detected on contrast-enhanced ultrasono-distal cologram yielded a specificity of 85.71% and a positive predictive value of 97.73%.

Contrast-enhanced ultrasono-distal cologram showed an overall accuracy of 98%.

“

Conclusion · 1 of 2

Contrast-enhanced ultrasono-distal cologram demonstrated excellent diagnostic accuracy and almost perfect agreement with fluoroscopic distal cologram, indicating high reliability and reproducibility in detecting fistulae with genitourinary tract in children with anorectal malformation.

Conclusion · 2 of 2

contrast-enhanced ultrasono-distal cologram has great potential as an attractive radiation-free modality in the pre-operative workup of children with anorectal malformation.

Contrast-Enhanced Ultrasound in Children with Anorectal Malformations: A Radiation-Free Alternative to Fluoroscopy for Identifying Fistulae with Genitourinary Tract.

Contrast-Enhanced Ultrasound in Children with Anorectal Malformations: A Radiation-Free Alternative to Fluoroscopy for Identifying Fistulae with Genitourinary Tract.

Related papers