Improved Diagnostic Sensitivity of Bowel Disease of Prematurity on Contrast‐Enhanced Ultrasound

Abstract

Bowel diseases of prematurity, including necrotizing enterocolitis, are dreaded ailments of neonates. Early diagnosis is difficult, with clinical and radiographic findings often inconclusive. We present a novel use of contrast-enhanced ultrasound in detection of pediatric bowel disease. Early identification of compromised blood flow or an at-risk bowel can be quantitatively detected and monitored. This ability has implications for guidance of emerging therapies, allowing targeting of inflammation. These findings represent an advancement in detection of bowel disease in neonates.

Contrast-Enhanced Ultrasound in Children: Implementation and Key Diagnostic Applications

“…Another area for further study is the role of CEUS in the evaluation of infants with necrotizing enterocolitis [87,88].…”

Contrast-enhanced ultrasound of the pediatric bowel

“…A previous study with the use of SonoVue in children with Crohn disease calculated the UCA dose according to the formula: dose (mL) = child age (years) / 10, with a minimum 0.1 mL per single injection [ 12 ]. In another study, which included premature infants ranging in age from 1 day to 80 days at the time of CEUS, the reported total dose of Lumason for evaluating bowel perfusion was 0.4–0.6 mL [ 10 ].…”

“…However, CEUS applications for evaluating IBD in children are limited [ 9 – 12 ]. CEUS might also play a role when knowledge of bowel perfusion can help direct care in children with other bowel-related conditions, such as necrotizing enterocolitis, intussusception, appendicitis, epiploic appendagitis, vasculitis or other miscellaneous causes of hypo- or hyperperfusion [ 7 , 8 , 10 , 28 ]. These applications for CEUS are increasingly being explored.…”

Abdominal Ultrasound Assists the Diagnosis and Management of Necrotizing Enterocolitis

“…In the future, a novel contrast-enhanced ultrasound modality may provide a more accurate depiction of bowel vasculature than color Doppler ultrasound. A microbubble contrast agent, which is nonionizing radiation, could improve detection of decreased bowel perfusion 12,13. More studies are needed to evaluate the safety and efficacy of administering contrast agents to a neonate whose intestinal vascularity may be compromised.…”

“…A microbubble contrast agent, which is nonionizing radiation, could improve detection of decreased bowel perfusion. 12,13 More studies are needed to evaluate the safety and efficacy of administering contrast agents to a neonate whose intestinal vascularity may be compromised.…”