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:
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.
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
Processing time: 179 Days and 16.7 Hours
Research background

In a larger study, we will investigate the correlation between the size, location, age, weight and diagnostic accuracy of ulcers, and re-examine the children with peptic ulcer after regular treatment by gastrointestinal contrast-enhanced ultrasonography (CEUS).

Research motivation

CEUS has advantages in compliance, repeatability, incidence of complications, and tolerance of children, and has a high coincidence rate for clinical diagnosis. it can be used as a preliminary screening method for children with epigastric pain and an effective supplement to gastroscopy.

Research objectives

This study found that the diagnostic coincidence rate of conventional ultrasound was lower than that of gastrointestinal CEUS, and the results of gastrointestinal CEUS and gastroscopy were highly consistent, which confirmed that gastrointestinal CEUS had some advantages. The research on gastrointestinal CEUS in children was supplemented and improved. At present, gastrointestinal CEUS is not widely used in children, and it is necessary to establish the norms and standards of CEUS examination in children, which is helpful to better guide ultrasound physicians to carry out examination and improve the accuracy of examination.

Research methods

The contrast agents used in CEUS examination are food-grade contrast agents, which are safe, with no adverse effects or smell, and easy to drink. The contrast medium is a little sweet, easy for children to accept, and there is no need for intravenous sedative or general anesthesia. The examination process is painless, greatly reducing the anxiety of children and their families. The sound velocity and impedance of the contrast medium are similar to those of the liver. After oral administration of the contrast medium, the stomach and duodenum show uniform, medium and high dotted echoes, and at the same time, the gastric emptying time is prolonged. Under the gastrointestinal transmission window, the gastrointestinal wall structure and its pathological changes can be displayed more clearly. CEUS can also observe gastric peristalsis and extragastric tissue, and improve the diagnosis of gastroduodenal diseases.

Research results

The main goal of this study was to find the most suitable preliminary screening method for the diagnosis of peptic ulcer in children. For children who have contraindications for gastroscopy, CEUS can be a new option. For children with recurrent abdominal pain and other upper gastrointestinal symptoms with unknown etiology, gastrointestinal CEUS can provide a reference for clinical selection of appropriate treatment. For children with peptic ulcer who have been diagnosed and received regular drug treatment, the curative effect can be observed and evaluated repeatedly.

Research conclusions

The common examination methods for upper gastrointestinal ulcer in children include upper gastrointestinal X-ray barium meal examination, gastroscopy, gastric computed tomography, and gastric CEUS. In children, it is particularly important to find a simple, noninvasive examination method. CEUS is simple and noninvasive, the examination process is not painful, and there is no need for sedation or anesthesia, especially for children. It is expected to become a routine examination method for the diagnosis of digestive diseases in children.

Research perspectives

The detection rate of peptic ulcer in children is increasing, with developments in diagnostic procedures. Most children show abdominal pain, but cannot accurately describe it, so it is easy to miss diagnosis, misdiagnose, and delay treatment. Gastroscopy is the gold standard for the diagnosis of peptic ulcer, but it is an invasive examination. To maximize the diagnostic efficiency and reduce the risk, gastrointestinal CEUS screening is feasible before gastroscopy as an effective supplement to gastroscopy.