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The study\u2019s 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\u2019s disease were examined ex vivo using the Vevo MD UHF70 (MHz) probe delivering 30\u00a0\u03bcm-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\u00a0mm; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; CI 0.148\u20130.289), the ratio of thickness of muscularis interna\/muscularis externa was greater (1.194 vs. 0.846; <jats:italic>p<\/jats:italic>\u2009=\u20090.011; CI 0.085\u20130.596), and the submucosa\u2019s echogenicity was lower (100.0 vs. 115.3; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; CI \u2212 21.8 to \u2212 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.<\/jats:p>","DOI":"10.1038\/s41598-025-99897-7","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T18:59:39Z","timestamp":1745953179000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The use of ultra-high frequency ultrasound in identifying aganglionosis in Hirschsprung\u2019s disease"],"prefix":"10.1038","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7661-5592","authenticated-orcid":false,"given":"Tebin","family":"Hawez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Evertsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Erl\u00f6v","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6843-8995","authenticated-orcid":false,"given":"Kristine","family":"Hagelsteen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5663-035X","authenticated-orcid":false,"given":"Louise","family":"Tofft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0749-2362","authenticated-orcid":false,"given":"Tomas","family":"Jansson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0826-8963","authenticated-orcid":false,"given":"Magnus","family":"Cinthio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6498-6145","authenticated-orcid":false,"given":"Christina","family":"Gran\u00e9li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5052-9944","authenticated-orcid":false,"given":"Pernilla","family":"Stenstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"99897_CR1","unstructured":"European Commission. 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