The use of ultra-high frequency ultrasound in identifying aganglionosis in Hirschsprung’s disease

To make surgery more precise and to shorten anesthesia-times for children undergoing surgery for Hirschsprung's disease, ultra-high frequency ultrasound (UHFUS) has been suggested to replace peroperative biopsy. The study's aim was to determine quantitatively whether aganglionic and ganglionic bowel segments could be distinguished by UHFUS. Bowel specimens of 23 children operated on for rectosigmoid Hirschsprung's disease were examined ex vivo using the Vevo MD UHF70 (MHz) probe delivering 30 μm-resolution. In ganglionic versus aganglionic bowel in UHFUS images, patients serving their own controls, the thickness of the muscularis interna was thicker (0.540 vs. 0.322 mm; p < 0.001; CI 0.148-0.289), the ratio of thickness of muscularis interna/muscularis externa was greater (1.194 vs. 0.846; p = 0.011; CI 0.085-0.596), and the submucosa's echogenicity was lower (100.0 vs. 115.3; p < 0.001; CI - 21.8 to - 8.7). The results indicate that delineation between aganglionosis and ganglionosis can be undertaken by UHFUS, underlining important research for precise diagnostics with UHFUS in vivo.