Ultrasound examination in diagnosis and monitoring of necrotizing enterocolitis in a group of newborns with birth weight below 2000 g – a preliminary report

Gwizdała, Dominika; Wilczyńska, Małgorzata; Talar, Tomasz; Gulczyńska, Ewa; Biegański, Tadeusz

doi:10.17772/gp/1653

Cited by 4 publications

(6 citation statements)

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“…In 2013, a case report showed that bowel distension and intraluminal gas were frequently detected in NEC neonates, and bowel wall thickening together with increased bowel wall perfusion was observed in nine patients. This work suggested that US examination can be helpful in the initial diagnosis as well as the follow-up of patients developing NEC (23). Another study reported that PVG, BD, and bowel wall thickening frequencies in the NEC group were higher in the US protocol than in plain X-rays (24), which is consistent with our results and suggests a diagnostic value and disease evaluation significance of abdominal US inspection for neonatal NEC.…”

Section: ' Discussionsupporting

confidence: 90%

Efficacy of abdominal ultrasound inspection in the diagnosis and prognosis of neonatal necrotizing enterocolitis

Gao

Mao

et al. 2021

Clinics

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OBJECTIVE: This study aimed to identify the most useful ultrasound (US) features associated with definite neonatal necrotizing enterocolitis (NEC) and their prognostic values, particularly the calculated markers combined with important features. METHODS: A total of 213 suspected NEC cases were collected from the neonatal department of our hospital from January 2015 to August 2017. Each infant received both X-ray and US examinations. RESULTS: No differences were found in sex composition and delivery modes between groups. NEC-positive neonates had poorer prognosis compared to negative ones. The NEC group showed a higher frequency of abnormal signals. US showed higher NEC-related frequencies in different parameters. A variable (named predictor in US [PUS]) with five features was constructed. For NEC diagnosis, this variable provided a much higher area under the curve Q2 (AUC) (0.965) than other parameters. In this model, PUS had a cutoff value of 0.376 with a 0.900 sensitivity and 0.922 specificity. In prognosis, the closest factors were selected to draw a receiver operating characteristic curve, as well as a novel calculated variable US prognostic (USPro) marker. USPro had a much higher AUC (0.86) than other single features and showed a cutoff value of 0.18145, with 0.75 sensitivity and 0.84 specificity. This variable had a weaker power in prognosis when compared with PUS in diagnosis. CONCLUSIONS: The application of abdominal color Doppler US can provide high accuracy and sensitivity in NEC diagnosis and also contribute to its prognosis, without induction of radiation. Suspected neonates should be examined using this technique as early as possible.

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Section: ' Discussionsupporting

confidence: 90%

Efficacy of abdominal ultrasound inspection in the diagnosis and prognosis of neonatal necrotizing enterocolitis

Gao

Mao

et al. 2021

Clinics

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“…Numerous studies13–15 19 29–34 support the use of Faingold et al 35 and Epelman et al ’s27 techniques for a standardised sonographic protocol for greyscale and CD AUS. Faingold recently published a standard protocol for performing AUS for NEC,20 recommending systematically assessing each quadrant of the abdomen by scanning in transverse and sagittal planes.…”

Section: Use Of Aus In Nec For Diagnosis and Managementmentioning

confidence: 98%

“…Colour Doppler AUS findings of absent transmural blood flow are indicative of this later stage. Finally, greyscale AUS showing bowel wall thinning and absent perfusion is highly suggestive of impending bowel perforation 32 33 48 73. Black framed boxes indicate abdominal radiograph (AR)/AUS features of NEC.…”

Section: Differential Clinical and Imaging Findingsmentioning

confidence: 99%

“…34 48 49 51 PI and PVG remain the hallmarks of NEC on ARs 7 17 19 27 30. Bowel wall thickness, bowel wall texture, bowel necrosis53 and bowel peristalsis are all much more difficult to evaluate by AR compared with AUS 20 32 35 54. Changes in these AUS variables can provide earlier evidence of disease progression before bowel perforation 12 27 35 53 55…”

Section: Differential Clinical and Imaging Findingsmentioning

confidence: 99%

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Abdominal ultrasound should become part of standard care for early diagnosis and management of necrotising enterocolitis: a narrative review

Druten

Khashu

Chan

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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Necrotising enterocolitis (NEC) is a leading cause of death and disability in preterm newborns. Early diagnosis through non-invasive investigations is a crucial strategy that can significantly improve outcomes. Hence, this review gives particular attention to the emerging role of abdominal ultrasound (AUS) in the early diagnosis of NEC, its performance against abdominal radiograph and the benefits of AUS use in daily practice. AUS has been used in the diagnosis and management of NEC for a couple of decades. However, its first-line use has been minimal, despite growing evidence demonstrating AUS can be a critical tool in the early diagnosis and management of NEC. In 2018, the NEC group of the International Neonatal Consortium recommended using AUS to detect pneumatosis and/or portal air in preterm NEC as part of the ‘Two out of three’ model. To facilitate widespread adoption, and future improvement in practice and outcomes, collaboration between neonatologists, surgeons and radiologists is needed to generate standard operating procedures and indications for use for AUS. The pace and scale of the benefit generated by use of AUS can be amplified through use of computer-aided detection and artificial intelligence.

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“…However, it is sometimes impossible to expose patients to consecutive episodes of radiation. Ultrasound examination (US) seems to be an alternative to current standard usage of radiography [ 40 ]. US is an ideal modality for evaluating bowel necrosis as it is non-invasive, does not involve the use of ionizing radiation and can be performed readily at the bedside.…”

Section: Introductionmentioning

confidence: 99%

Current status of laboratory and imaging diagnosis of neonatal necrotizing enterocolitis

et al. 2018

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Necrotizing enterocolitis continues to be a devastating disease process for very low birth weight infants in Neonatal Intensive Care Units. The aetiology and pathogenesis of necrotizing enterocolitis are not definitively understood. It is known that necrotizing enterocolitis is secondary to a complex interaction of multiple factors that results in mucosal damage, which leads to intestinal ischemia and necrosis. Advances in neonatal care, including resuscitation and ventilation support technology, have seen increased survival rates among premature neonates and a concomitant detection in the incidence of this intestinal disease.Diagnosis can be difficult, and identifying infants at the onset of disease remains a challenge. Early diagnosis, which relies on imaging findings, and initiation of prompt therapy are essential to limit morbidity and mortality. Moreover, early management is critical and life-saving.This review summarizes what is known on the laboratory and instrumental diagnostic strategies needed to improve neonatal outcomes and, possibily, to prevent the onset of an overt necrotizing enterocolitis.

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Ultrasound examination in diagnosis and monitoring of necrotizing enterocolitis in a group of newborns with birth weight below 2000 g – a preliminary report

Cited by 4 publications

References 0 publications

Efficacy of abdominal ultrasound inspection in the diagnosis and prognosis of neonatal necrotizing enterocolitis

Efficacy of abdominal ultrasound inspection in the diagnosis and prognosis of neonatal necrotizing enterocolitis

Abdominal ultrasound should become part of standard care for early diagnosis and management of necrotising enterocolitis: a narrative review

Current status of laboratory and imaging diagnosis of neonatal necrotizing enterocolitis

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