title: Ultrasonography and radiography findings predicted the need for surgery in patients with necrotising enterocolitis without pneumoperitoneum.
abstract: OBJECTIVE
  The timing of surgical intervention in patients with necrotising enterocolitis (NEC) without pneumoperitoneum remains unclear. This study aimed to identify the predictors associated with surgical intervention in such patients and to assess how effective imaging reports were as an aid to surgical decision-making.
  
  
  METHODS
  We collected clinical data, laboratory investigations and imaging findings on NEC patients without pneumoperitoneum. A critical imaging report was defined as persistent dilation of bowel loops and evidence of portal venous gas on radiography and thickening of the bowel wall, absent peristalsis and evidence of echogenic-free fluid on sonography. Independent predictors of surgical NEC were identified using multivariate logistic regression analysis. Sensitivity and specificity analyses were performed for the imaging findings, and receiver operator characteristic curve analysis was used to evaluate the predictive accuracy.
  
  
  RESULTS
  Of the 238 neonates studied, 54 (22.69%) required surgical intervention. The multivariate logistic regression analysis showed that abdominal erythema, C-reactive protein levels and the critical imaging report were independent predictors of the need for surgical intervention. The critical imaging report was the most powerful predictor of surgical NEC.
  
  
  CONCLUSIONS
  Both ultrasonography and radiography findings proved helpful in predicting the need for surgery in NEC without pneumoperitoneum.
authors.affiliation: Department of Neonatology, Children's Hospital, Chongqing Medical University, Chongqing, China.|Chongqing Key Laboratory of Paediatrics, Chongqing, China.|Ministry of Education Key Laboratory of Child Development and Disorder, Children's Hospital, Chongqing Medical University, Chongqing, China.|China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Neonatology, The Children's Hospital Zhejiang University School of Medicine, Chongqing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhong
authors.affiliation: Department of Neonatology, Children's Hospital, Chongqing Medical University, Chongqing, China.|Chongqing Key Laboratory of Paediatrics, Chongqing, China.|Ministry of Education Key Laboratory of Child Development and Disorder, Children's Hospital, Chongqing Medical University, Chongqing, China.|China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.
authors.forename: Jialin
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Neonatology, Children's Hospital, Chongqing Medical University, Chongqing, China.|Chongqing Key Laboratory of Paediatrics, Chongqing, China.|Ministry of Education Key Laboratory of Child Development and Disorder, Children's Hospital, Chongqing Medical University, Chongqing, China.|China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Cheng
authors.affiliation: Department of Neonatology, Children's Hospital, Chongqing Medical University, Chongqing, China.|Chongqing Key Laboratory of Paediatrics, Chongqing, China.|Ministry of Education Key Laboratory of Child Development and Disorder, Children's Hospital, Chongqing Medical University, Chongqing, China.|China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.
authors.forename: Zhengli
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Neonatology, Children's Hospital, Chongqing Medical University, Chongqing, China.|Chongqing Key Laboratory of Paediatrics, Chongqing, China.|Ministry of Education Key Laboratory of Child Development and Disorder, Children's Hospital, Chongqing Medical University, Chongqing, China.|China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.
authors.forename: Luquan
authors.initials: L
authors.lastname: Li
mesh_terms: D020345:Enterocolitis, Necrotizing / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D011027:Pneumoperitoneum; D011859:Radiography; D012189:Retrospective Studies; D014463:Ultrasonography
keywords: Imaging reports; Multivariate analysis; Necrotising enterocolitis; Risk factors; Surgery