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Efficacy of bowel ultrasound to diagnose necrotizing enterocolitis in extremely low birthweight infants
O V Ionov1,2,3, D R Sharafutdinova1,2, A B Sugak1
1National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov of the Ministry of Health of the Russian Federation, Moscow, Russia.
Background:
Bowel ultrasound (US) is one of the methods used to enhance diagnostic accuracy of necrotizing enterocolitis (NEC) and its associated complications in premature newborns.
Aim:
To explore the diagnostic accuracy of bowel US in extremely low birth weight (ELBW) infants with NEC.
Methods:
A single-center retrospective case-control study included 84 extremely low birth weight (ELBW) infants. The infants were divided into three groups: Group 1 -infants with NEC (n = 26); Group 2 -infants with feeding problems (n = 28); Group 3 -control group (n = 30).
Results:
The specific bowel US findings in premature newborns with NEC (stage 3) included bowel wall thinning, complex (echogenic) ascites, and pneumoperitoneum, p < 0.05. The diagnostic effectiveness of these sonographic signs was 96.8% (sensitivity 75.0% and specificity 97.6%), p < 0.05. These findings with high specificity were associated with the need for surgical intervention, poor outcomes, or increased mortality. Stage 2 NEC which did not require surgery showed impaired differentiation of the bowel wall layers, absent or decreased bowel peristalsis, pneumatosis intestinalis, portal venous gas, or simple ascites, with a diagnostic accuracy of 82.9% (sensitivity 55.6%, specificity 91.4%, p < 0.05).
Conclusions:
Bowel US can be used as an adjunct to abdominal radiography to aid in the diagnosis of infants with suspected NEC by providing more detailed evaluation of the intestine.
