Abstract
The present study aims to assess the value of the intestinal wall thickness, intestinal peristalsis combined with intestinal wall blood flow signal monitored by abdominal ultrasound (AUS) in the diagnosis of necrotizing enterocolitis (NEC) in low-birth-weight infants. Low-birth-weight (<2500 g) infants with Bell I (suspected NEC) and Bell II (definite NEC) were enrolled, and the entire cohort of 130 infants was divided into Bell I (n = 84) group and Bell II (n = 46) group. The general clinical characteristics, the intestinal wall activity parameters, including intestinal wall thickness, intestinal peristalsis, combined with intestinal wall blood flow signal obtained from AUS, as well as intramural gas and portal venous gas monitored by AUS and abdominal X-ray, were reviewed. The multivariable logistic regression analysis and the area under the receiver operating characteristic curve (AUCs) were used to assess the value of the above parameters for diagnosing NEC. The receiver operating characteristic curve analysis showed significant differences (P = .015) in the AUCs for AUS and abdominal X-ray examinations. Logistic regression analysis identified that intramural gas (P =.005, odds ratio [OR]: 4.98), thinned bowel wall (<1.5 mm) (P =.004, OR: 7.081), reduced peristalsis (P = .001, OR: 7.405), reduced intestinal wall blood flow signal (P = .002, OR: 9.074) of AUS were independent diagnostic factors for definite NEC. Furthermore, the AUC for the logistic model of AUS was 0.839 (95% confidence interval: 0.764-0.913), which showed superior ability in diagnosing NEC. In conclusion, the AUS examination plays a crucial role in diagnosing NEC earlier in low-birth-weight infants. Intestinal wall thickness, intestinal peristalsis, and combined with intestinal wall blood flow signal showed good diagnostic ability for NEC.