Bhattacharjee Indrani, Dolinger Michael Todd, Singh Rachana, Singh Yogen
Department of Pediatrics, Tufts University School of Medicine, Boston, MA 02111, USA.
Division of Pediatric Gastroenterology, NYU Grossman School of Medicine, New York, NY 10016, USA.
Diagnostics (Basel). 2025 Jul 23;15(15):1852. doi: 10.3390/diagnostics15151852.
Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease and a major cause of morbidity and mortality among preterm infants. Traditional diagnostic methods such as abdominal radiography have limited sensitivity in early disease stages, prompting interest in bowel ultrasound (BUS) as a complementary imaging modality. This scoping review aims to synthesize existing literature on the role of ultra sound in the early detection, diagnosis, and management of NEC, with emphasis on its diagnostic performance, integration into clinical care, and technological innovations. Following PRISMA-ScR guidelines, a systematic search was conducted across PubMed, Embase, Cochrane Library, and Google Scholar for studies published between January 2000 and December 2025. Inclusion criteria encompassed original research, reviews, and clinical studies evaluating the use of bowel, intestinal, or Doppler ultrasound in neonates with suspected or confirmed NEC. Data were extracted, categorized by study design, population characteristics, ultrasound features, and diagnostic outcomes, and qualitatively synthesized. A total of 101 studies were included. BUS demonstrated superior sensitivity over radiography in detecting early features of NEC, including bowel wall thickening, portal venous gas, and altered peristalsis. Doppler ultrasound, both antenatal and postnatal, was effective in identifying perfusion deficits predictive of NEC onset. Neonatologist-performed ultrasound (NEOBUS) showed high interobserver agreement when standardized protocols were used. Emerging tools such as ultra-high-frequency ultrasound (UHFUS) and artificial intelligence (AI)-enhanced analysis hold potential to improve diagnostic precision. Point-of-care ultrasound (POCUS) appears feasible in resource-limited settings, though implementation barriers remain. Bowel ultrasound is a valuable adjunct to conventional imaging in NEC diagnosis. Standardized protocols, validation of advanced technologies, and out come-based studies are essential to guide its broader clinical adoption.
坏死性小肠结肠炎（NEC）是一种严重的胃肠道疾病，是早产儿发病和死亡的主要原因。传统的诊断方法如腹部X线摄影在疾病早期阶段的敏感性有限，这促使人们对肠道超声（BUS）作为一种辅助成像方式产生兴趣。本综述旨在综合现有关于超声在NEC早期检测、诊断和管理中的作用的文献，重点关注其诊断性能、融入临床护理以及技术创新。按照PRISMA-ScR指南，在PubMed、Embase、Cochrane图书馆和谷歌学术上对2000年1月至2025年12月发表的研究进行了系统检索。纳入标准包括评估在疑似或确诊NEC的新生儿中使用肠道、小肠或多普勒超声的原始研究、综述和临床研究。提取数据，按研究设计、人群特征、超声特征和诊断结果进行分类，并进行定性综合。共纳入101项研究。在检测NEC的早期特征方面，BUS显示出比X线摄影更高的敏感性，包括肠壁增厚、门静脉气体和蠕动改变。产前和产后的多普勒超声在识别预测NEC发病的灌注缺陷方面有效。当使用标准化方案时，新生儿科医生进行的超声检查（NEOBUS）显示出较高的观察者间一致性。诸如超高频率超声（UHFUS）和人工智能（AI）增强分析等新兴工具具有提高诊断精度的潜力。即时超声检查（POCUS）在资源有限的环境中似乎可行，尽管实施障碍仍然存在。肠道超声是NEC诊断中传统成像的有价值辅助手段。标准化方案、先进技术的验证以及基于结果的研究对于指导其更广泛的临床应用至关重要。
