Diagnostic efficacy of high-frequency ultrasound and X-ray contrast enema in colonic strictures after necrotizing enterocolitis: a retrospective study

Pediatr Surg Int. 2022 Dec 21;39(1):56. doi: 10.1007/s00383-022-05278-w.

Abstract

Objective: To compare the efficacy of high-frequency ultrasound and X-ray contrast enema in the diagnosis of colonic strictures after necrotizing enterocolitis.

Methods: This study included pediatric patients who developed progressive abdominal distension or constipation after conservative treatment for necrotizing enterocolitis at our hospital between June 2012 and April 2020. All patients had high-frequency ultrasounds and X-ray contrast enema, and we used surgery, pathology, and telephone return visits as the reference standard. Patients with colonic strictures were confirmed by surgery and pathology. A patient was considered without colonic stricture if no stricture was reported or did not have related symptoms during telephone return visits. The areas under the Receiver operating characteristic (ROC) curves were used as evaluation indexes to compare the differential efficacy of high-frequency ultrasound and X-ray contrast enema.

Results: A total of 81 patients have been included in this study. Among them, 49 patients were diagnosed with colonic strictures after necrotizing enterocolitis. The AUCs for high-frequency ultrasound and X-ray contrast enema were 0.990 vs 0.938, respectively (p > 0.05).

Conclusion: The diagnostic efficacy of high-frequency ultrasound was similar to that of X-ray contrast enema, furthermore this study also demonstrates the benefits of using high-frequency ultrasound to identify colonic strictures after necrotizing enterocolitis.

Keywords: Colonic strictures after necrotizing enterocolitis; Contrast enema; Efficacy; High-frequency ultrasound; NEC; Necrotizing enterocolitis.

MeSH terms

  • Child
  • Enema
  • Enterocolitis, Necrotizing* / complications
  • Enterocolitis, Necrotizing* / diagnostic imaging
  • Enterocolitis, Necrotizing* / therapy
  • Female
  • Fetal Diseases*
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases* / therapy
  • Intestinal Obstruction* / diagnostic imaging
  • Intestinal Obstruction* / etiology
  • Intestinal Obstruction* / therapy
  • Retrospective Studies
  • X-Rays