{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:03:35Z","timestamp":1789131815971,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T00:00:00Z","timestamp":1633392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Our aims were to evaluate the ultrasound scan (USS) criteria in diagnosing hypertrophic pyloric stenosis (HPS), determine the best diagnostic threshold values for pyloric muscle thickness (PMT) and pyloric canal length (PCL), and assess the accuracy of flow through the pylorus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients who underwent pyloromyotomy at our tertiary paediatric surgery centre between July 2013 and June 2019 were identified (Group 1). All patients undergoing an USS to investigate for a possible HPS and did not undergo pyloromyotomy were also identified (Group 2). Accuracy was determined by Youden's Index (<jats:italic>J<\/jats:italic>) with the highest <jats:italic>J<\/jats:italic> determining the ideal cut\u2010off value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and eighty\u2010four patients (142 patients in each group) were included in the analysis. Using only the last USS before surgery, PMT provided an area under the curve (AUC) of 0.987 (<jats:italic>n<\/jats:italic>\u00a0=\u2009275), and PCL an AUC of 0.977 (<jats:italic>n<\/jats:italic>\u00a0=\u2009267). Ideal threshold values were 3.0\u2009mm for PMT (<jats:italic>J<\/jats:italic>\u00a0=\u20090.92), and 14.5\u2009mm for PCL (<jats:italic>J<\/jats:italic>\u00a0=\u20090.87). Combining PMT \u22653.0\u2009mm with a PCL \u226514.5\u2009mm resulted in a sensitivity of 95% and specificity of 99% (J\u00a0=\u00a00.94). The absence of flow through the pylorus on dynamic USS provided a sensitivity of 99% and specificity of 91% (<jats:italic>J<\/jats:italic>\u00a0=\u20090.91; <jats:italic>n<\/jats:italic>\u00a0=\u2009277).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combining threshold values of 3.0\u2009mm for PMT and 14.5\u2009mm PCL provides the highest accuracy for diagnosing pyloric stenosis on an ultrasound scan. These combined values were more accurate than observing for the absence of flow through the pylorus.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17247","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T14:04:55Z","timestamp":1633615495000},"page":"2507-2513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluating the validity of ultrasound in diagnosing hypertrophic pyloric stenosis: a cross\u2010sectional diagnostic accuracy study"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8305-9208","authenticated-orcid":false,"given":"Toby","family":"Vinycomb","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery Monash Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Vanhaltren","sequence":"additional","affiliation":[{"name":"Department of Radiology Monash Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1259-4304","authenticated-orcid":false,"given":"Maurizio","family":"Pacilli","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Monash Children's Hospital  Melbourne Victoria Australia"},{"name":"Departments of Paediatrics and Surgery at the School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ditchfield","sequence":"additional","affiliation":[{"name":"Department of Radiology Monash Children's Hospital  Melbourne Victoria Australia"},{"name":"Departments of Radiology and Paediatrics Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4438-0263","authenticated-orcid":false,"given":"Ramesh Mark","family":"Nataraja","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Monash Children's Hospital  Melbourne Victoria Australia"},{"name":"Departments of Paediatrics and Surgery at the School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000192032.83843.c9"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197705192962006"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-008-1106-4"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02456287"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.150.6.1367"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.193.3.7972822"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002470050377"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/crad.2001.0853"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1673.2007.01872.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2012.03.068"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/12.966"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.178.3.1994426"},{"key":"e_1_2_10_14_1","first-page":"Ye01","article-title":"Requirements for minimum sample size for sensitivity and specificity analysis","volume":"10","author":"Bujang MA","year":"2016","journal-title":"J. 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