Gastro-oesophageal reflux in paediatric patients: evaluation with contrast enhanced ultrasound

Purpose: to prospectively evaluate the diagnostic capabilities of contrast-enhanced colour Doppler ultrasound (CEUS) in diagnosing gastro-oesophageal reflux. Materials and methods: 120 consecutive paediatric patients (68 males and 52 females, aged 1 months-2 years) with clinical symptoms of gastro-oesophageal reflux underwent CEUS examination with an AU-5 IDEA US scanner (Esaote Biomedica) with a 3.5 MHz convex probe. US examinations were compared with twenty-four hours Ph-metry available in all patients and considered as the gold standard. The results were compared using the Mc Nemar test. Results: CEUD enabled the identification of the oesophageal tract involved in the reflux. Disease prevalence was 71.7%. CEUS showed sensitivity of 97.7% (95% CI: 94.5%-100%), specificity of 100% (95% CI: 100%-100%), accuracy of 98.3%, predictive positive value of 100%, predictive negative value of 94.4%. Statistical correlation at Mc Nemar test was high (p< 0.0001). No side effects occurred. Conclusion: CEUS is a non-invasive imaging technique that allows an accurate evaluation of gastro-oesophageal reflux. Because of the lack of radiation exposure, CEUS should be used as the preferred method for diagnosis and follow-up of gastro-oesophageal reflux in paediatric patients.