Ultrasound role in diagnosis and as an assisting tool in prognostication of surgery in neonates with necrotizing enterocolitis
Objective: Abdominal ultrasonography (AUS) assessment of the neonatal abdomen is emerging as a potential useful addition to traditional abdominal radiographs (AXR) to confirm the diagnosis of necrotizing enterocolitis (NEC). The goal of this study was to assess the abdominal sonographic findings of...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
|
| Series: | WFUMB Ultrasound Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949668324000168 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846124882784419840 |
|---|---|
| author | Elham Zarei Mehdi Vafadar Amir S. Mounesi Sohi Jilla Armandeh Ehsan Ranjbar |
| author_facet | Elham Zarei Mehdi Vafadar Amir S. Mounesi Sohi Jilla Armandeh Ehsan Ranjbar |
| author_sort | Elham Zarei |
| collection | DOAJ |
| description | Objective: Abdominal ultrasonography (AUS) assessment of the neonatal abdomen is emerging as a potential useful addition to traditional abdominal radiographs (AXR) to confirm the diagnosis of necrotizing enterocolitis (NEC). The goal of this study was to assess the abdominal sonographic findings of premature infants with NEC, in order to determine whether AUS is more effective than AXR in the diagnosis of NEC. Methods: This cross-sectional study was performed on consecutive neonates with clinical suspicion of NEC admitted in our hospital’s NICU (Ali-Asghar Children’s Hospital, Tehran, Iran). We prospectively evaluated the hospitalized subjects using AXR and AUS from May 2018 to May 2020. Results: A total of 53 neonates were included in the study. These patients were divided into two groups: suspected NEC patients (stage I) including 31 subjects and definite NEC patients (stage II and III) including 22 neonates. We found a substantial agreement between the two modalities regarding the detection of pneumoperitoneum and pneumatosis intestinalis (κ: 0·658 for both). The concordance concerning portal venous gas detection was considered slight (κ: 0·315). Thirty-eight patients did not show any signs of portal venous gas in either of AUS or AXR. On the contrary, four patients demonstrated evidences of portal venous gas in both AUS and AXR. AUS detected ten more portal venous gas than AXR. AXR found no cases with positive portal venous gas that were undetected by AUS. The most predictive indicator for surgical intervention in neonates was the presence of free echogenic ascites and loculated fluid. Conclusion: Our findings demonstrated that AUS is superior to AXR in demonstrating portal venous gas and pneumatosis intestinalis. Hence, it seems that AUS is a useful adjunct to AXR in the management of NEC. |
| format | Article |
| id | doaj-art-f3bf5f38eb92460c8f2216925b48f427 |
| institution | Kabale University |
| issn | 2949-6683 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | WFUMB Ultrasound Open |
| spelling | doaj-art-f3bf5f38eb92460c8f2216925b48f4272024-12-13T11:09:11ZengElsevierWFUMB Ultrasound Open2949-66832024-12-0122100048Ultrasound role in diagnosis and as an assisting tool in prognostication of surgery in neonates with necrotizing enterocolitisElham Zarei0Mehdi Vafadar1Amir S. Mounesi Sohi2Jilla Armandeh3Ehsan Ranjbar4Ali Asghar children hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Shahid Dastjerdi Street, QC8G+W9C, 19198 16766, IranAli Asghar children hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Shahid Dastjerdi Street, QC8G+W9C, 19198 16766, IranDepartment of Radiology, School of Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, 14496-14535, IranDepartment of Radiology, School of Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, 14496-14535, IranSchool of Medicine, Tehran University of Medical Sciences, Tehran, District 6, Pour Sina St, P94V+8MF, Iran; Corresponding author. School of medicine, Tehran University of Medical Sciences, Tehran Province, Tehran, District 6, Pour Sina St, P94V+8MF, Iran.Objective: Abdominal ultrasonography (AUS) assessment of the neonatal abdomen is emerging as a potential useful addition to traditional abdominal radiographs (AXR) to confirm the diagnosis of necrotizing enterocolitis (NEC). The goal of this study was to assess the abdominal sonographic findings of premature infants with NEC, in order to determine whether AUS is more effective than AXR in the diagnosis of NEC. Methods: This cross-sectional study was performed on consecutive neonates with clinical suspicion of NEC admitted in our hospital’s NICU (Ali-Asghar Children’s Hospital, Tehran, Iran). We prospectively evaluated the hospitalized subjects using AXR and AUS from May 2018 to May 2020. Results: A total of 53 neonates were included in the study. These patients were divided into two groups: suspected NEC patients (stage I) including 31 subjects and definite NEC patients (stage II and III) including 22 neonates. We found a substantial agreement between the two modalities regarding the detection of pneumoperitoneum and pneumatosis intestinalis (κ: 0·658 for both). The concordance concerning portal venous gas detection was considered slight (κ: 0·315). Thirty-eight patients did not show any signs of portal venous gas in either of AUS or AXR. On the contrary, four patients demonstrated evidences of portal venous gas in both AUS and AXR. AUS detected ten more portal venous gas than AXR. AXR found no cases with positive portal venous gas that were undetected by AUS. The most predictive indicator for surgical intervention in neonates was the presence of free echogenic ascites and loculated fluid. Conclusion: Our findings demonstrated that AUS is superior to AXR in demonstrating portal venous gas and pneumatosis intestinalis. Hence, it seems that AUS is a useful adjunct to AXR in the management of NEC.http://www.sciencedirect.com/science/article/pii/S2949668324000168Necrotizing enterocolitisAbdominal radiographAbdominal ultrasonography |
| spellingShingle | Elham Zarei Mehdi Vafadar Amir S. Mounesi Sohi Jilla Armandeh Ehsan Ranjbar Ultrasound role in diagnosis and as an assisting tool in prognostication of surgery in neonates with necrotizing enterocolitis WFUMB Ultrasound Open Necrotizing enterocolitis Abdominal radiograph Abdominal ultrasonography |
| title | Ultrasound role in diagnosis and as an assisting tool in prognostication of surgery in neonates with necrotizing enterocolitis |
| title_full | Ultrasound role in diagnosis and as an assisting tool in prognostication of surgery in neonates with necrotizing enterocolitis |
| title_fullStr | Ultrasound role in diagnosis and as an assisting tool in prognostication of surgery in neonates with necrotizing enterocolitis |
| title_full_unstemmed | Ultrasound role in diagnosis and as an assisting tool in prognostication of surgery in neonates with necrotizing enterocolitis |
| title_short | Ultrasound role in diagnosis and as an assisting tool in prognostication of surgery in neonates with necrotizing enterocolitis |
| title_sort | ultrasound role in diagnosis and as an assisting tool in prognostication of surgery in neonates with necrotizing enterocolitis |
| topic | Necrotizing enterocolitis Abdominal radiograph Abdominal ultrasonography |
| url | http://www.sciencedirect.com/science/article/pii/S2949668324000168 |
| work_keys_str_mv | AT elhamzarei ultrasoundroleindiagnosisandasanassistingtoolinprognosticationofsurgeryinneonateswithnecrotizingenterocolitis AT mehdivafadar ultrasoundroleindiagnosisandasanassistingtoolinprognosticationofsurgeryinneonateswithnecrotizingenterocolitis AT amirsmounesisohi ultrasoundroleindiagnosisandasanassistingtoolinprognosticationofsurgeryinneonateswithnecrotizingenterocolitis AT jillaarmandeh ultrasoundroleindiagnosisandasanassistingtoolinprognosticationofsurgeryinneonateswithnecrotizingenterocolitis AT ehsanranjbar ultrasoundroleindiagnosisandasanassistingtoolinprognosticationofsurgeryinneonateswithnecrotizingenterocolitis |