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Diagnostic value of the acute angle between the prestenotic and poststenotic duodenum in neonatal annular pancreas.

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Title: Diagnostic value of the acute angle between the prestenotic and poststenotic duodenum in neonatal annular pancreas.
Authors: Yang, Boyang1, He, Fan2, He, Qiuming3, Wang, Zhe3, Fang, Qian1, Zhong, Wei3 gzfezw@163.com, Wang, Hongying1 gzfe1122@163.com
Source: European Radiology. Jun2019, Vol. 29 Issue 6, p2902-2909. 8p. 2 Color Photographs, 1 Black and White Photograph, 1 Chart, 1 Graph.
Subjects: Duodenal obstructions, Duodenum, Pancreas, Receiver operating characteristic curves
Abstract: Objectives: To analyze the ability of upper gastrointestinal (GI) saline-contrast ultrasound (US) to detect neonatal annular pancreas.Methods: Sixty-two neonates, who presented duodenal obstruction and were examined by upper GI saline-contrast US before treatment, were retrospectively analyzed and categorized into four groups according to their final diagnosis: group A, annular pancreas (n = 28); group B, duodenal atresia (n = 2); group C, descending duodenal septum (n = 25); and group D, normal (n = 7). The ultrasonic characteristics were analyzed that especially focused on whether the angle between the prestenotic and poststenotic descending duodenum (at or below a derived cutoff) could identify neonatal annular pancreas.Results: To detect annular pancreas using the concave contour of the distal prestenotic duodenum, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined at 71.4%, 100%, 100%, and 80.9%, respectively. When using the hyperechogenic band around the constricted duodenum, the sensitivity, specificity, PPV, and NPV were determined at 82.1%, 94.1%, 92%, and 86.5%, respectively. For using the 40.7° acute angle cutoff between prestenotic and poststenotic descending duodenum, the values of sensitivity, specificity, PPV, and NPV were determined at 100%, 97.1%, 96.6%, and 100%, respectively, of which the area under the receiver operating characteristic curve was 0.979.Conclusions: Upper GI saline-contrast US has a lower possibility for misdiagnosis of neonatal annular pancreas when considering the acute angle between the prestenotic and poststenotic descending duodenum.Key Points: • This study includes the largest series of neonates with annular pancreas of which the characteristics were analyzed using the upper GI saline-contrast US. • Neonatal annular pancreas may be diagnosed by the characteristics-concave contour of the distal prestenotic duodenum; acute angle cutoff of 40.7° between the prestenotic and poststenotic duodenum; the "S" shape formed by the pylorus, the duodenal bulb, and the prestenotic and poststenotic descending duodenum. • The acute angle with the highest diagnostic value can be used to quantitatively diagnose neonatal annular pancreas and avoid potential misdiagnosis caused by sonographers' subjectivity. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Diagnostic value of the acute angle between the prestenotic and poststenotic duodenum in neonatal annular pancreas.
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  Data: <searchLink fieldCode="AR" term="%22Yang%2C+Boyang%22">Yang, Boyang</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22He%2C+Fan%22">He, Fan</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22He%2C+Qiuming%22">He, Qiuming</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Wang%2C+Zhe%22">Wang, Zhe</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Fang%2C+Qian%22">Fang, Qian</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Zhong%2C+Wei%22">Zhong, Wei</searchLink><relatesTo>3</relatesTo><i> gzfezw@163.com</i><br /><searchLink fieldCode="AR" term="%22Wang%2C+Hongying%22">Wang, Hongying</searchLink><relatesTo>1</relatesTo><i> gzfe1122@163.com</i>
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Jun2019, Vol. 29 Issue 6, p2902-2909. 8p. 2 Color Photographs, 1 Black and White Photograph, 1 Chart, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Duodenal+obstructions%22">Duodenal obstructions</searchLink><br /><searchLink fieldCode="DE" term="%22Duodenum%22">Duodenum</searchLink><br /><searchLink fieldCode="DE" term="%22Pancreas%22">Pancreas</searchLink><br /><searchLink fieldCode="DE" term="%22Receiver+operating+characteristic+curves%22">Receiver operating characteristic curves</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: <bold>Objectives: </bold>To analyze the ability of upper gastrointestinal (GI) saline-contrast ultrasound (US) to detect neonatal annular pancreas.<bold>Methods: </bold>Sixty-two neonates, who presented duodenal obstruction and were examined by upper GI saline-contrast US before treatment, were retrospectively analyzed and categorized into four groups according to their final diagnosis: group A, annular pancreas (n = 28); group B, duodenal atresia (n = 2); group C, descending duodenal septum (n = 25); and group D, normal (n = 7). The ultrasonic characteristics were analyzed that especially focused on whether the angle between the prestenotic and poststenotic descending duodenum (at or below a derived cutoff) could identify neonatal annular pancreas.<bold>Results: </bold>To detect annular pancreas using the concave contour of the distal prestenotic duodenum, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined at 71.4%, 100%, 100%, and 80.9%, respectively. When using the hyperechogenic band around the constricted duodenum, the sensitivity, specificity, PPV, and NPV were determined at 82.1%, 94.1%, 92%, and 86.5%, respectively. For using the 40.7° acute angle cutoff between prestenotic and poststenotic descending duodenum, the values of sensitivity, specificity, PPV, and NPV were determined at 100%, 97.1%, 96.6%, and 100%, respectively, of which the area under the receiver operating characteristic curve was 0.979.<bold>Conclusions: </bold>Upper GI saline-contrast US has a lower possibility for misdiagnosis of neonatal annular pancreas when considering the acute angle between the prestenotic and poststenotic descending duodenum.<bold>Key Points: </bold>• This study includes the largest series of neonates with annular pancreas of which the characteristics were analyzed using the upper GI saline-contrast US. • Neonatal annular pancreas may be diagnosed by the characteristics-concave contour of the distal prestenotic duodenum; acute angle cutoff of 40.7° between the prestenotic and poststenotic duodenum; the "S" shape formed by the pylorus, the duodenal bulb, and the prestenotic and poststenotic descending duodenum. • The acute angle with the highest diagnostic value can be used to quantitatively diagnose neonatal annular pancreas and avoid potential misdiagnosis caused by sonographers' subjectivity. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00330-018-5922-0
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      – Code: eng
        Text: English
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        PageCount: 8
        StartPage: 2902
    Subjects:
      – SubjectFull: Duodenal obstructions
        Type: general
      – SubjectFull: Duodenum
        Type: general
      – SubjectFull: Pancreas
        Type: general
      – SubjectFull: Receiver operating characteristic curves
        Type: general
    Titles:
      – TitleFull: Diagnostic value of the acute angle between the prestenotic and poststenotic duodenum in neonatal annular pancreas.
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            NameFull: Yang, Boyang
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            NameFull: He, Fan
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              M: 06
              Text: Jun2019
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              Y: 2019
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