Early Diagnosis Of Neonatal Necrotizing Enterocolitis By Ultrasound: A Pilot Study

PARTⅠ ULTRASOUND MEASUREMENTS OF INTESTINAL WALL THICKNESS AND INTESTINAL WALL BLOOD PERFUSION IN NORMAL NEWBORNSObjective: To establish normal standard reference values of intestinal wall thickness and intestinal wall blood perfusion in normal newborns.To provide imaging evidence for the early diagnosis of neonatal necrotizing enterocolitis and the severity of neonatal necrotizing enterocolitis.Methods: The thickness of the intestinal wall of 422 normal newborns was measured,including 246 males,176 females,222 term infants and 82 preterm infants.They were divided into two groups: 222 cases of full term infants and 200 cases of premature infants.Among them,there were 164 cases of 0~7 days of age,129 cases of 7~14 days of age,and 129 cases of 14~28 days of age.Blood perfusion of intestinal wall per unit area(cm2)of 322 normal newborns was measured,including 180 cases of male and female 142 cases,which were divided into two groups: 174 cases of full term infants and 148 cases of premature infants.Among them,126 cases were 0~7 days of age,101 cases with age of 7~14 days,and 95 cases with age of 14~28 days.Results: There was a statistically significant difference in the intestinal wall thickness between the full-term and the premature,and also difference in newborns with different weight(P<0.05).There was no statistically significant difference in the thickness of intestinal wall between different gender and intestinal tract(P > 0.05).There was no significant difference in the ultrasonic measurement of intestinal wall perfusion in different sex,body weight,intestinal tract and Whether full-term or not(P >0.05).Conclusion: The reference range of intestinal wall thickness and blood perfusion of intestinal wall in normal newborns was established.PARTⅡEARLY DIAGNOSIS OF NEONATAL NECROTIZING ENTEROCOLITIS BY ULTRASOUND: A PILOT STUDYObjective: To explore the diagnostic value of ultrasonography in neonatal Necrotizing enterocolitis(NEC),and to provide help for early diagnosis of NEC.Methods: Using the same method,63 cases of children diagnosed with NEC were examined by high frequency,color Doppler and spectrum Doppler.Their intestinal wall thickness and intestinal wall blood perfusion were measured.The clinical data and imaging data of 63 children with NEC were collected.Results: There was a statistically significant difference in the intestinal wall thickness between the intestinal and corresponding parts of the full term infants and the preterm infants in the case group and the control group(P<0.05).There was a statistically significant difference in the number of intestinal blood flow per unit area(cm2)between the case group and the control group(P < 0.05).The proportion of the abdominal ultrasound found in the portal venous gas was higher than that of the abdominal X-ray,and the difference was statistically significant(P < 0.05),and there was no significant difference in intestinal wall pneumatosis between the abdominal ultrasonography and the abdominal X-ray(P>0.05).Conclusion: Ultrasound examination can help the early diagnosis of NEC,and can be used as a preferred method for clinical evaluation of NEC.