Document Detail


Necrotizing enterocolitis: assessment of bowel viability with color doppler US.
MedLine Citation:
PMID:  15858098     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine whether absence of bowel wall perfusion at color Doppler ultrasonography (US) is indicative of bowel necrosis in neonates with necrotizing enterocolitis (NEC). MATERIALS AND METHODS: This study was approved by the research ethics board, and informed consent was obtained. Sixty-two neonates enrolled in the prospective study underwent US of the bowel wall. Neonates were divided into two groups. Group A included 30 control subjects with gestational ages (GAs) ranging from 24 to 41 weeks. Group B included 32 neonates with GAs ranging from 24 to 40 weeks who were clinically proved to have or suspected of having NEC. All neonates in group B underwent abdominal radiography. Normative values were calculated in group A. In group B, the sensitivities and specificities of color Doppler US and abdominal radiography for detection of bowel necrosis were computed by using the modified Bell staging criteria for NEC as the reference standard. RESULTS: Two neonates were excluded from group B; thus, a total of 60 neonates were included in the study. In group A, bowel wall thickness ranged from 1.1 to 2.6 mm. Bowel wall perfusion was detected with color Doppler US in all 30 neonates. Color Doppler signals ranged from one to nine dots per square centimeter. Twenty-two of 30 neonates in group B received a diagnosis of NEC. Mild to moderate NEC was diagnosed in 12 neonates. Color Doppler US depicted an isolated segment of bowel-absent blood flow in two neonates; this finding was confirmed with laparotomy. In 10 neonates with severe NEC, color Doppler US depicted isolated or multiple segments of bowel with absent perfusion. Pneumoperitoneum was present in only four neonates. The remaining eight neonates at risk for NEC had no evidence of loops without perfusion at color Doppler US. The sensitivity of free air at abdominal radiography as a positive sign for severe NEC with necrotic bowel was 40% compared with the 100% sensitivity of absence of flow at color Doppler US (P = .03). CONCLUSION: Color Doppler US is more accurate than abdominal radiography in depicting bowel necrosis in NEC.
Authors:
Ricardo Faingold; Alan Daneman; George Tomlinson; Paul S Babyn; David E Manson; Arun Mohanta; Aideen M Moore; Jonathan Hellmann; Charles Smith; Ted Gerstle; Jae Hong Kim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  235     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-28     Completed Date:  2005-05-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  587-94     Citation Subset:  AIM; IM    
Copyright Information:
(c) RSNA, 2005.
Affiliation:
Department of Diagnostic Imaging, Division of Neonatology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada. ricardo.faingold@muhc.mcgill.ca
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MeSH Terms
Descriptor/Qualifier:
Enterocolitis, Necrotizing / pathology,  surgery,  ultrasonography*
Female
Fourier Analysis
Humans
Infant, Newborn
Infant, Premature, Diseases / pathology,  surgery,  ultrasonography*
Intestines / blood supply*,  pathology,  surgery
Ischemia / ultrasonography
Male
Muscle, Smooth / blood supply*,  pathology,  surgery
Pneumoperitoneum / diagnosis
Prospective Studies
Reference Values
Regional Blood Flow / physiology
Sensitivity and Specificity
Tissue Survival / physiology*
Ultrasonography, Doppler, Color*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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