title: Quantitative assessment of hepatic blood flow in the diagnosis and management of necrotizing enterocolitis.
abstract: BACKGROUND
  Necrotizing enterocolitis (NEC) is the most important gastrointestinal emergency in the neonatal period and early detection is very important for its management. Bowel ischemia-hypoperfusion is one of the main etiological factors. In the literature, a few studies have focused on arterial Doppler ultrasonography (DUS) features of splanchnic arteries; however, their clinical implications are not clear.
  
  
  OBJECTIVE
  In this study, we aimed to quantitatively evaluate the blood flow features in the hepatic portal vein (PV) and hepatic veins (HVs) by using DUS in newborns with NEC. Patient-Method: Enrolled subjects were divided into two groups as patient (suspected/confirmed NEC, n = 24), and control group (n = 25). Daily serial DUS examinations were performed after the onset of the suspicion of NEC and continued until the initial day of the enteral feeding. Portal blood flow (PBF) and "hepatic blood flow ratio" (RHBF) were calculated manually by using DUS findings. Two groups were compared with respect to their PBF and RoHBF values.
  
  
  RESULTS
  PBF and RHBF levels were significantly lower in patient group than those in control group. Clinical improvement in patients with NEC was associated with improvement in the PBF and RHBF. Cut-off level of the RHBF for the diagnosis of NEC was 0.66.
  
  
  CONCLUSIONS
  DUS seems to be useful for the diagnosis and follow-up of NEC by providing quantitative information on liver blood flow. Daily measurements of the PBF and RoHBF in newborns with NEC may be beneficial to make the decision of starting enteral feeding.
authors.affiliation: a Division of Neonatology, Department of Pediatrics and.
authors.forename: Mustafa Ali
authors.initials: MA
authors.lastname: Akin
authors.affiliation: b Division of Pediatric Radiology, Department of Radiology, Faculty of Medicine , Erciyes University , Kayseri , Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Yikilmaz
authors.affiliation: a Division of Neonatology, Department of Pediatrics and.
authors.forename: Tamer
authors.initials: T
authors.lastname: Gunes
authors.affiliation: a Division of Neonatology, Department of Pediatrics and.
authors.forename: Dilek
authors.initials: D
authors.lastname: Sarici
authors.affiliation: a Division of Neonatology, Department of Pediatrics and.
authors.forename: Levent
authors.initials: L
authors.lastname: Korkmaz
authors.affiliation: a Division of Neonatology, Department of Pediatrics and.
authors.forename: M Adnan
authors.initials: MA
authors.lastname: Ozturk
authors.affiliation: a Division of Neonatology, Department of Pediatrics and.
authors.forename: Selim
authors.initials: S
authors.lastname: Kurtoglu
mesh_terms: D016022:Case-Control Studies; D020345:Enterocolitis, Necrotizing / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006503:Hepatic Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D008102:Liver Circulation; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D018608:Ultrasonography, Doppler
keywords: Blood flow velocity; liver; necrotizing enterocolitis