Sonographic evaluation of neonates with early-stage necrotizing enterocolitis
Sonographic evaluation of neonates with early-stage necrotizing enterocolitis
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DOI：
10.1007/s00247-005-1533-4
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发表时间：
2005-11-01
影响因子：
2.3
通讯作者：
Lee, EK
中科院分区：
文献类型：
--
作者：
Kim, WY;Kim, WS;Lee, EK
背景：坏死性小肠结肠炎（NEC）是新生儿重症监护病房最常见的胃肠道急症。早期NEC的超声检查结果尚未被描述。目的：探讨超声检查对NEC的诊断和监测价值。材料与方法：本文对40例出生2-28天临床诊断为NEC的新生儿早期NEC的超声表现进行了分析。她们的平均胎龄为32周，平均体重为1，850 g。所有患者在腹部X线片上均表现出肠道膨胀的迹象，但没有证据表明存在肠积气。我们对所有患者（n = 40）以及10名健康新生儿（作为对照组）进行了肠道超声检查。从2003年2月至2004年1月，使用10 MHz线性换能器进行了研究。我们在初始和随访检查时评估了肠壁、受累区域、腹水和门静脉气体的回声。我们根据肠壁回声类型将患者分为两组，I组为肠壁回声点，II组为肠壁回声密集颗粒。为了确定超声检查和临床结果之间的任何相关性，我们评估了每组的胃肠外喂养（NPO）持续时间，并通过统计分析（Mann-Whitney检验）比较了两组。结果如下：对照组10例，肠壁回声均正常，NEC组16例（40%）肠壁回声呈点状，24例（60%）肠壁回声呈致密颗粒状。所有患者均无门静脉气体。在随访检查中，37例（93%）患者的肠壁和腹水回声降低。NPO持续时间I组为11.1 ± 6.6天，II组为16.5 ± 7.2天（P < 0.05）。结论：早期NEC患者肠壁可见点状或密集颗粒状回声。肠道超声检查有助于NEC的早期诊断和监测。
Background: Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in neonatal intensive care units. Ultrasonographic findings in early-stage NEC have not been described. Objective: To assess the diagnostic value of ultrasonography for the diagnosis and monitoring of patients with NEC. Materials and methods: We evaluated the sonographic findings of early stages of NEC in 40 neonates who were clinically diagnosed with NEC when they were 2-28 days old. Their average gestational age was 32 weeks, and their mean weight was 1,850 g. All of the patients showed signs of bowel distention on abdominal radiography, with no evidence of pneumatosis intestinalis. We performed bowel sonography in all patients (n = 40), as well as in ten healthy neonates who served as a control group. The studies were conducted with a 10-MHz linear transducer from February 2003 to January 2004. We evaluated the echogenicity of the bowel wall, involved region, ascites, and portal venous gas at both initial and follow-up examinations. We divided the patients into two groups according to the bowel wall echogenicity pattern, group I with echogenic dots in the bowel wall and group II with dense granular echogenicities in the bowel wall. In order to identify any correlations between the ultrasonography and clinical findings, we evaluated the duration of parenteral feeding (NPO) in each group and compared two groups by means of a statistical analysis (Mann-Whitney test). Results: All of the neonates in the control group (n = 10) presented normal bowel wall echogenicity; the patients with NEC presented echogenic dots in 16 patients (40%) and dense granular echogenicities in 24 patients (60%). Portal venous gas was absent in all patients. On the follow-up examinations, the echogenicity of the bowel wall and ascites decreased in 37 patients (93%). The duration of NPO was 11.1 +/- 6.6 days in group I and 16.5 +/- 7.2 days in group II (P < 0.05). Conclusion: Echogenic dots or dense granular echogenicities in the bowel wall can be seen in patients with early-stage NEC. Bowel sonography can be helpful for the early diagnosis and monitoring of patients with NEC.