ACR–SPR PRACTICE PARAMETER FOR THE PERFORMANCE OF PEDIATRIC FLUOROSCOPIC CONTRAST ENEMA EXAMINATIONS

PREAMBLE

I. INTRODUCTION

II. INDICATIONS AND CONTRAINDICATIONS

III. QUALIFICATIONS OF PERSONNEL

IV. SPECIFICATIONS OF THE EXAMINATION

A. Conventional Diagnostic Contrast Enema

IV. SPECIFICATIONS OF THE EXAMINATION

B. Intussusception

IV. SPECIFICATIONS OF THE EXAMINATION

C. Distal Bowel Obstruction in Neonates [31]

IV. SPECIFICATIONS OF THE EXAMINATION

D. Hirschsprung Disease [8,31,34-36]

IV. SPECIFICATIONS OF THE EXAMINATION

E. Meconium Ileus of the Neonate [31,40,41]

IV. SPECIFICATIONS OF THE EXAMINATION

F. The following steps are suggested for a quality control program:

V. DOCUMENTATION

VI. EQUIPMENT SPECIFICATIONS

VII. RADIATION SAFETY IN IMAGING

VIII. QUALITY CONTROL AND IMPROVEMENT, SAFETY, INFECTION CONTROL, AND PATIENT EDUCATION

ACKNOWLEDGEMENTS

REFERENCES

1. American College of Radiology. ACR-SPR Practice Parameter for Imaging Pregnant or Potentially Pregnant Patients with Ionizing Radiation. Available at: https://gravitas.acr.org/PPTS/GetDocumentView?docId=23+&releaseId=2.
2. American College of Radiology. ACR Committee on Drugs and Contrast Media. Manual on Contrast Media. Available at: https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Contrast-Manual.
3. American College of Radiology. ACR-AAPM-SIIM Practice Parameter for Digital Radiography. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=135+&releaseId=2
4. American College of Radiology. ACR-AAPM Technical Standard for Management of the Use of Radiation in Fluoroscopic Procedures. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=197+&releaseId=2
5. Koppen IJ, Yacob D, Di Lorenzo C, et al. Assessing colonic anatomy normal values based on air contrast enemas in children younger than 6 years. Pediatric Radiology. 47(3):306-312, 2017 Mar.
6. Lee HH, Lee JJ, Lee JJ, Choe YY. Is colonoscopy necessary in children suspected of having colonic polyps?. Gut Liver 4:326-31, .
7. Rao AA, Simmons CC, Thacker PP, Collins HH, Ritenour EE, Hill JJ. Radiation exposure contribution of the scout abdomen radiograph in common pediatric fluoroscopic procedures. Pediatr Radiol 46:1241-8, .
8. BERDON WE, BAKER DH. THE ROENTGENOGRAPHIC DIAGNOSIS OF HIRSCHSPRUNG'S DISEASE IN INFANCY. Am J Roentgenol Radium Ther Nucl Med. 1965 Feb;93():432-46.
9. Nguyen HN, Kan JH, Guillerman RP, Cassady CI. Intussusception revisited: is immediate on-site surgeon availability at the time of reduction necessary?. AJR. American Journal of Roentgenology. 202(2):432-6, 2014 Feb.
10. Johnson BB, Gargiullo PP, Murphy TT, Parashar UU, Patel MM. Factors associated with bowel resection among infants with intussusception in the United States. Pediatr Emerg Care 28:529-32, .
11. Fallon SC, Lopez ME, Zhang W, et al. Risk factors for surgery in pediatric intussusception in the era of pneumatic reduction. Journal of Pediatric Surgery. 48(5):1032-6, 2013 May.
12. American College of Radiology. ACR–SIR–SPR Practice Parameter on Informed Consent for Image-Guided Procedures. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=176+&releaseId=2
13. Al-Tokhais TT, Hsieh HH, Pemberton JJ, Elnahas AA, Puligandla PP, Flageole HH. Antibiotics administration before enema reduction of intussusception: is it necessary?. J Pediatr Surg 47:928-30, .
14. Gluckman S, Karpelowsky J, Webster AC, McGee RG. Management for intussusception in children. [Review]. Cochrane Database of Systematic Reviews. 6:CD006476, 2017 Jun 01.
15. Daneman AA, Navarro OO. Intussusception. Part 2: An update on the evolution of management. Pediatr Radiol 34:97-108; quiz 187, .
16. Navarro OO, Daneman AA. Intussusception. Part 3: Diagnosis and management of those with an identifiable or predisposing cause and those that reduce spontaneously. Pediatr Radiol 34:305-12; quiz 369, .
17. del-Pozo G, Albillos JC, Tejedor D, et al. Intussusception in children: current concepts in diagnosis and enema reduction. Radiographics. 1999;19(2):299-319.
18. Britton I, Wilkinson AG. Ultrasound features of intussusception predicting outcome of air enema. Pediatr Radiol. 1999 Sep;29(9):705-10.
19. Lee JH, Choi SH, Jeong YK, et al. Intermittent sonographic guidance in air enemas for reduction of childhood intussusception. J Ultrasound Med. 25(9):1125-30, 2006 Sep.
20. Chew R, Ditchfield M, Paul E, Goergen SK. Comparison of safety and efficacy of image-guided enema reduction techniques for paediatric intussusception: A review of the literature. [Review]. Journal of Medical Imaging & Radiation Oncology. 61(6):711-717, 2017 Dec.
21. Shiels WW, Bisset GG, Kirks DD. Simple device for air reduction of intussusception. Pediatr Radiol 20:472-4, .
22. Applegate KK. Intussusception in children: imaging choices. Semin Roentgenol 43:15-21, .
23. Gu LL, Alton DD, Daneman AA, et al. John Caffey Award. Intussusception reduction in children by rectal insufflation of air. AJR Am J Roentgenol 150:1345-8, .
24. Shiels WW, Kirks DD, Keller GG, et al. John Caffey Award. Colonic perforation by air and liquid enemas: comparison study in young pigs. AJR Am J Roentgenol 160:931-5, .
25. Shiels WW, Maves CC, Hedlund GG, Kirks DD. Air enema for diagnosis and reduction of intussusception: clinical experience and pressure correlates. Radiology 181:169-72, .
26. Beres AA, Baird RR. An institutional analysis and systematic review with meta-analysis of pneumatic versus hydrostatic reduction for pediatric intussusception. Surgery 154:328-34, .
27. Betz BW, Hagedorn JE, Guikema JS, Barnes CL. Therapeutic enema for pediatric ileocolic intussusception: using a balloon catheter improves efficacy. Emergency Radiology. 20(5):385-91, 2013 Oct.
28. Ntoulia A, Tharakan SJ, Reid JR, Mahboubi S. Failed Intussusception Reduction in Children: Correlation Between Radiologic, Surgical, and Pathologic Findings. AJR. American Journal of Roentgenology. 207(2):424-33, 2016 Aug.
29. Navarro OO, Daneman AA, Chae AA. Intussusception: the use of delayed, repeated reduction attempts and the management of intussusceptions due to pathologic lead points in pediatric patients. AJR Am J Roentgenol 182:1169-76, .
30. Hernanz-Schulman M, Foster C, Maxa R, et al. Experimental study of mortality and morbidity of contrast media and standardized fecal dose in the peritoneal cavity. Pediatr Radiol. 2000 Jun;30(6):369-78.
31. Carroll AG, Kavanagh RG, Ni Leidhin C, Cullinan NM, Lavelle LP, Malone DE. Comparative Effectiveness of Imaging Modalities for the Diagnosis of Intestinal Obstruction in Neonates and Infants:: A Critically Appraised Topic. [Review]. Academic Radiology. 23(5):559-68, 2016 May.
32. Buonpane CC, Lautz TT, Hu YY. Should we look for Hirschsprung disease in all children with meconium plug syndrome?. J Pediatr Surg 54:1164-1167, .
33. Ballisty MM, Braithwaite KA, Shehata BM, Dickson PN. Imaging findings in megacystis-microcolon-intestinal hypoperistalsis syndrome. [Review]. Pediatric Radiology. 43(4):454-9, 2013 Apr.
34. Proctor ML, Traubici J, Langer JC, et al. Correlation between radiographic transition zone and level of aganglionosis in Hirschsprung's disease: Implications for surgical approach. J Pediatr Surg. 2003 May;38(5):775-8.
35. Reid JR, Buonomo C, Moreira C, Kozakevich H, Nurko SJ. The barium enema in constipation: comparison with rectal manometry and biopsy to exclude Hirschsprung's disease after the neonatal period. Pediatr Radiol. 2000 Oct;30(10):681-4.
36. Stranzinger EE, DiPietro MM, Teitelbaum DD, Strouse PP. Imaging of total colonic Hirschsprung disease. Pediatr Radiol 38:1162-70, .
37. Frongia GG, Günther PP, Schenk JJ, et al. Contrast Enema for Hirschsprung Disease Investigation: Diagnostic Accuracy and Validity for Subsequent Diagnostic and Surgical Planning. Eur J Pediatr Surg 26:207-14, .
38. Muller CC, Mignot CC, Belarbi NN, Berrebi DD, Bonnard AA. Does the radiographic transition zone correlate with the level of aganglionosis on the specimen in Hirschsprung's disease?. Pediatr Surg Int 28:597-601, .
39. Putnam LL, John SS, Greenfield SS, et al. The utility of the contrast enema in neonates with suspected Hirschsprung disease. J Pediatr Surg 50:963-6, .
40. Carlyle BB, Borowitz DD, Glick PP. A review of pathophysiology and management of fetuses and neonates with meconium ileus for the pediatric surgeon. J Pediatr Surg 47:772-81, .
41. Cho HH, Cheon JE, Choi YH, et al. Ultrasound-guided contrast enema for meconium obstruction in very low birth weight infants: Factors that affect treatment success. Eur J Radiol. 84(10):2024-31, 2015 Oct.
42. Jamieson D, Stringer D. Small Bowel. In: Babyn PS, Stringer DA, ed. Pediatric Gastrointestinal Imaging and Intervention. 2nd ed. Hamilton, Ontario: Decker; 2000:311-32.
43. Kao SS, Franken EE. Nonoperative treatment of simple meconium ileus: a survey of the Society for Pediatric Radiology. Pediatr Radiol 25:97-100, .
44. Rescorla FJ, Grosfeld JL. Contemporary management of meconium ileus. World J Surg. 1993;17(3):318-325.
45. Ziegler MM. Meconium ileus. Curr Probl Surg 31:731-77, .
46. American College of Radiology. ACR Practice Parameter for Communication of Diagnostic Imaging Findings. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=74+&releaseId=2
47. American College of Radiology. ACR-AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Radiographic Equipment. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=120+&releaseId=2