DOI: 10.1177/87564793261474505 ISSN: 8756-4793

The Diagnostic Accuracy of Abdominal Radiography and Bowel Ultrasonography for the Diagnosis of Necrotizing Enterocolitis

Shima Shamsaei, Masoud Mahdavi Rashed, Seyed Ali Alamdaran, Abbas Boskabadi, Shabnam Niroumand, Saleh Ghorbani
Show PDF Cite

Objective:

Necrotizing enterocolitis (NEC) is a destructive infantile disease with the highest mortality, which requires surgery. This study investigated and compared the diagnostic accuracy of abdominal radiography (AR), bowel ultrasonography (BUS), and Doppler for infants with suspected NEC stages I-III.

Materials and Methods:

Eighty-four infants with risk factors for NEC were enrolled and categorized into suspected (stage I) and final diagnostic (stages II-III) patient groups, based on Bell’s criteria. Gray-scale sonography and Doppler diagnostic findings were analyzed using Faingold’s criteria and compared with AR. The descriptive characteristics, such as maternal factors, and infant mortality, were recorded.

Results:

Most of the study neonates were males (59.5%) and had suspected NEC (57.1%). Of the 48 infants with suspected NEC, 20 were reclassified as definite NEC based on sonographic findings. Eighteen patients (21.4%) died, predominantly in the definite NEC group (72.2%, P  = .005). All AR and BUS findings, except fluid collections, differed significantly between groups ( P  < .05). Bowel loop dilatation showed 60% to 65% diagnostic accuracy, 50% to 52% specificity, and 80% sensitivity. Pneumatosis intestinalis, portal venous gas, and pneumoperitoneum had similar diagnostic accuracy but different sensitivities and specificities. Doppler was used to identify avascular loops in 18 patients, all with a final diagnosis of NEC ( P  < .001), with 74.3% diagnostic accuracy, 66.6% specificity, and 83.7% sensitivity.

Conclusion:

In this cohort of patients, gray-scale sonography, Doppler, and AR parameters had acceptable diagnostic accuracy, although sensitivity and specificity varied.

More from our Archive