[Imaging assessment of neonatal necrotizing enterocolitis].
OBJECTIVE
To improve the understanding of recognizing and diagnosis of neonatal necrotizing enterocolitis (NEC), imaging assessment of neonates with NEC was analyzed retrospectively.


METHODS
Data of 211 cases of NEC were retrospectively collected from the Department of Neonatology, Children's Hospital of Chongqing Medical University between Jan.1(st) 2006-Dec.31(st) 2011.


RESULTS
Analysis of abdominal X-ray of 211 cases showed that there were 40 cases (19.0%) who had no changes on each X-ray, 47 cases (22.3%) had improvement and 23 cases (10.9%) became worse. In the group of no changes, positive rate with good prognosis was 97.5% and with poor prognosis, it was 2.5%. In the group of improvement, positive rate with good prognosis was 97.9%, and the contrary was 2.1%. Positive rate with good prognosis was 56.5%, and the contrary was 43.5% in worse group. Chi-square analysis of the three groups showed χ(2) = 31.742, P < 0.01. Comparison of detection rate of pneumoperitoneum on abdominal X-ray (16.0%, 12/75) and Doppler US (1.3%, 1/75), χ(2) = 10.191, P < 0.05, portal pneumatosis on abdominal X-ray(1.3%, 1/75) versus Doppler US (12.0%,9/75), χ(2) = 6.857, P < 0.05. Surgical timing mostly corresponded to pneumoperitoneum (OR = 19.543) and intestinal obstruction (OR = 19.527) of abdominal X-ray. The logistic regression equation is y = -2.915-1.588x1+2.972x4+2.973x7 + 1.711x9 (χ(2) = 101.705, P < 0.01).


CONCLUSIONS
Abdominal X-ray is the most important method of diagnosis of NEC, the group of deterioration of abdominal X-ray has obvious bad prognosis differ from no change group and better group. Comparison with abdominal X-ray and Doppler US, the former in pneumoperitoneum positive rate was higher than the latter, at the same time, portal pneumatosis on Doppler US is more sensitive to abdominal X-ray, the value of two imaging assessments both supplement each other. Surgical timing mostly corresponds to pneumoperitoneum and intestinal obstruction.
Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
Jia-Rong
JR
Wang
Jia-Lin
JL
Yu
Guang-Hong
GH
Li
Min
M
Wang
Bo
B
Gao
Hui-Fan
HF
Li
Jia-Bin
JB
Chen
Cong
C
Zhang
D000005:Abdomen / Q000000981:diagnostic imaging* / Q000601:surgery; D001724:Birth Weight; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D007234:Infant, Premature; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000601:surgery; D016015:Logistic Models; D008297:Male; D011027:Pneumoperitoneum / Q000175:diagnosis / Q000000981:diagnostic imaging; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color