Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.
Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Pediatr Radiol. 2022 Apr;52(4):702-715. doi: 10.1007/s00247-021-05187-5. Epub 2021 Oct 16.
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.
超声已被证明是提高坏死性小肠结肠炎及其相关并发症诊断准确性的有用手段。评估坏死性小肠结肠炎的标准成像算法包括 X 光片和临床症状，两者结合构成了 Bell 标准。使用 Bell 标准诊断和临床管理坏死性小肠结肠炎的主要局限性包括 X 光片的诊断准确性低和早产儿的非特异性症状。在这方面，US 可以通过帮助描述肠动力、回声、厚度、气肿和灌注来提供对肠道健康的额外了解。还可以评估壁外表现，如门静脉气体、腹水的性质和程度以及气腹。最近，对比增强超声在一系列早产儿肠道疾病中进行了探索，其诊断效用值得进一步研究。本文回顾了坏死性小肠结肠炎的 US 特征，并强调了 US 作为 X 光片的补充的作用，以及对比增强超声在坏死性小肠结肠炎中的新兴应用。
