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The role of ultrasound in necrotizing enterocolitis

  • Neonatal imaging
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Abstract

Ultrasound has proved to be a useful modality for enhancing the diagnostic accuracy of necrotizing enterocolitis and associated complications. The standard imaging algorithm for evaluating necrotizing enterocolitis includes radiographs and clinical symptoms, the combination of which constitutes the Bell criteria. Major limitations of using the Bell criteria for diagnosing and clinically managing necrotizing enterocolitis include low diagnostic accuracy of radiographs and nonspecific symptomatology of preterm infants. In this regard, US can offer additional insights into bowel health by helping to characterize bowel motility, echogenicity, thickness, pneumatosis and perfusion. Extramural findings such as portal venous gas, nature and extent of ascites, and pneumoperitoneum can also be assessed. Recently, contrast-enhanced US was explored in a case series of preterm bowel disease and its diagnostic utility warrants further investigation. This article reviews the US features of necrotizing enterocolitis and highlights the role of US as a complement to radiographs, as well as the emerging use of contrast-enhanced US in necrotizing enterocolitis.

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  1. Department of Radiology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA

    Misun Hwang, Luis O. Tierradentro-García, Rebecca A. Dennis & Sudha A. Anupindi

  2. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Misun Hwang, Rebecca A. Dennis & Sudha A. Anupindi

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  1. Misun Hwang
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Correspondence to Misun Hwang.

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Dr. Hwang received an investigator-initiated grant from Bracco Diagnostics Inc.

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Hwang, M., Tierradentro-García, L.O., Dennis, R.A. et al. The role of ultrasound in necrotizing enterocolitis. Pediatr Radiol 52, 702–715 (2022). https://doi.org/10.1007/s00247-021-05187-5

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