Doppler flowmetry of the superior mesenteric artery and portal vein: impact for the early prediction of necrotizing enterocolitis in neonates

Pediatr Surg Int. 2015 Nov;31(11):1061-6. doi: 10.1007/s00383-015-3792-y. Epub 2015 Sep 29.

Abstract

Purpose: Necrotizing enterocolitis (NEC) is a serious gastrointestinal disorder in newborns. Early diagnosis and rapid treatment is essential for seeking good outcome for neonates. The aim of our study was to evaluate intestinal blood flow in superior mesenteric artery (SMA) and portal vein (PV) in neonates with suspected or confirmed NEC and investigate the prognostic cut-off values to develop NEC.

Methods: Doppler flowmetry of SMA and PV was performed for 62 newborns. Resistive (RI) and pulsatility (PI) indexes were measured in SMA as well as Volumetric blood flow (Vflow) in PV. ROC curves were applied to estimate sensitivity and specificity and to identify cut-off values.

Results: There were 93.5% preterm neonates. 29 patients (46.8%) were diagnosed with NEC and 33 (53.2%) formed a control group. 96.3% NEC patients had RI >0.75 with sensitivity of 96.3% and specificity of 90.9% (OR 260). 88.9% NEC patients had PI >1.85 with sensitivity of 88.9% and specificity of 78.8% (OR 29). Portal Vflow lower than 37 ml/min was present in 89.7% patients with NEC (OR 11.7).

Conclusion: Intestinal blood flow Dopplerography can be a useful tool for diagnosing and predicting NEC.

Keywords: Doppler flowmetry; Necrotizing enterocolitis; Portal vein; Superior mesenteric artery.

MeSH terms

  • Blood Flow Velocity
  • Enterocolitis, Necrotizing / diagnostic imaging*
  • Female
  • Hemodynamics
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / diagnostic imaging*
  • Laser-Doppler Flowmetry*
  • Male
  • Mesenteric Artery, Superior / diagnostic imaging*
  • Portal Vein / diagnostic imaging*
  • Prospective Studies
  • Sensitivity and Specificity
  • Ultrasonography