TY - JOUR AU - YUAN, Peng AU - HOU, Jinping AU - WANG, Yi PY - 2023 TI - Comparison of diagnostic efficacy in males with high/intermediate typed anorectal malformations between ultrasound and inverted X-ray exam JO - Journal of Army Medical University SN - 2097-0927 SP - 1197 EP - 1203 VL - 45 IS - 11 AB - ObjectiveTo compare the diagnostic efficacy of ultrasound and inverted X-ray in differentiating high and intermediate types of male anorectal malformations(ARMs).MethodsA fully paired diagnostic accuracy study was conducted on 146 male children with intermediate/high type ARMs who were treated in our hospital from March 2013 to March 2022. According to their postoperative diagnosis after anorectal plasty, 55 cases(including 12 with bladder-neck fistula and 43 with urethral-prostatic fistula)were assigned into high type group and 91 cases(including 65 with urethral-bulbar fistula and 26 without fistula)into intermediate type group. The accuracy, sensitivity, specificity, and area under the curve(AUC)were used as evaluation indicators to compare the diagnostic efficacy of 2 examinations and the optimal diagnostic cutoff values by receiver operating characteristic(ROC)curve analysis. And the diagnostic efficacy of ultrasound and inverted X-ray was then compared in different time periods after birth.ResultsBoth examinations effectively differentiated high and intermediate types of male ARMs(P<0.05). The ROC curve analysis showed that the AUC of ultrasound(0.835, 95%CI: 0.764~0.891)was higher than that of inverted X-ray(0.759, 95%CI: 0.681~0.826), though without significant difference(P=0.061). The cut-off value of ultrasound(15.0 mm)was shorter than that of inverted X-ray(24.0 mm). The diagnostic efficacy of ultrasound(0.940, 95%CI: 0.799~0.993)was significant higher than that of inverted X-ray(0.758, 95%CI: 0.578~0.890)when inspection time was longer than 48 h after birth(P=0.032).ConclusionBoth ultrasound and inverted X-ray can differentiate intermediate and high type ARMs in male neonates. Ultrasound is more recommended for the neonates older than 48 h. UR - https://doi.org/10.16016/j.2097-0927.202208172 DO - 10.16016/j.2097-0927.202208172