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Background/Purpose: In Hirschsprung disease (HD) surgery, confirming ganglionic bowel is essential. A faster diagnostic method than the current frozen biopsy is desirable. This study investigated whether aganglionic and ganglionic intestinal wall can be distinguished from each other by ultra high frequency ultrasound (UHF ultrasound). Methods: In an HD center during 2019, intestinal walls of recto-sigmoid specimens from HD patients were examined ex vivo with a 70 MHz UHF ultrasound transducer. Data from four sites were described. Histopathologic analysis was compared to the ultrasonography outcome at each site. Each patient's specimen served as its own control. Results: 11 resected recto-sigmoid specimens (median 20 cm long [range 6.5-33]) with transition zones of 5 cm (2-11 cm) were taken from children aged 22 days (13-48) weighing 3668 g (3500-5508); 44 key sites were analyzed. There was full concordance for 42/44 (95%) key sites and 10 of 11 (91%) specimens. The specimen with discordance of two key sites contained a segment of aganglionosis (3 cm) and a transition zone (1 cm): the site discordance was limited to the transition zone ends. Conclusions: This first report on UHF ultrasound in recto-sigmoid HD shows promising results in identifying aganglionosis, transition zones and ganglionic bowel. Further in vivo studies are required.

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Ultrasound optical tomography (UOT) is an imaging technique based on the acoustooptic effect that can perform optical imaging with ultrasound resolution inside turbid media, and is thus interesting for biomedical applications, e.g. for assessing tissue blood oxygenation. In this paper, we present near background free measurements of UOT signal strengths using slow light filter signal detection. We carefully analyze each part of our experimental setup and match measured signal strengths with calculations based on diffusion theory. This agreement between experiment and theory allows us to assert the deep tissue imaging potential of ∼ 5 cm for UOT of real human tissues predicted by previous theoretical studies [ Biomed. Opt. Express 8, 4523 (2017)] with greater confidence, and indicate that future theoretical analysis of optimized UOT systems can be expected to be reliable.