Comparison of bedside abdominal ultrasonography and abdominal radiography in predicting surgical intervention in neonatal necrotising enterocolitis.
Bedside ultrasonography outperformed abdominal x-ray at predicting need for surgery in necrotising enterocolitis.
Comparison of bedside abdominal ultrasonography and abdominal radiography in predicting surgical intervention in neonatal necrotising enterocolitis.
To compare bedside ultrasonography (ultrasonography) and abdominal radiography (AXR) within the same cohort for their ability to discriminate the need for surgical intervention in neonatal necrotising enterocolitis (necrotising enterocolitis), and to evaluate the value of combining the two modalities.
A total of 509 neonates admitted to our neonatal intensive care unit from January 2015 to December 2023 were included; all had a clinical diagnosis of necrotising enterocolitis and underwent abdominal radiography (a supine cot-side view in all infants, with an additional erect view obtained in the radiology department only when the infant was stable enough to be transported) and bedside ultrasonography within 24 h.
AUC for ultrasonography; 1.0 is perfect prediction, 0.5 is chance.
The surgical group had a lower gestational age [33.0(30.0, 36.0) week] and birth weight [1,730(1,235, 2,205) g] than the conservative group (35.0[32.0, 36.0] week; 2,200[1,727.5, 2,732.5] g; both P < 0.001).
On the DeLong test, both the ultrasonography and combined models were superior to the AXR model (both P < 0.001), whereas the difference between them was not significant ( P = 0.067).
For neonates with a clinical diagnosis of necrotising enterocolitis, bedside ultrasonography was superior to AXR in the overall discrimination of the need for surgical intervention.
AXR portal venous gas and pneumoperitoneum were complementary to the ultrasonography findings of complex peritoneal effusion and peritoneal effusion; although adding AXR to ultrasonography did not raise the AUC over ultrasonography alone, it still added value in reclassifying borderline cases.
ultrasonography and AXR may serve as complementary modalities in the routine imaging work-up of necrotising enterocolitis.