Contrast-Enhanced Ultrasound and Near-Infrared Spectroscopy of the Neonatal Bowel: Novel, Bedside, Noninvasive, and Radiation-Free Imaging for Early Detection of Necrotizing Enterocolitis

Suzanne Al-Hamad; David J. Hackam; Seth D. Goldstein; Thierry A. G. M. Huisman; Kassa Darge; Misun Hwang

doi:10.1055/s-0038-1655768

American Journal of Perinatology, Table of Contents

Am J Perinatol 2018; 35(14): 1358-1365
DOI: 10.1055/s-0038-1655768

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Contrast-Enhanced Ultrasound and Near-Infrared Spectroscopy of the Neonatal Bowel: Novel, Bedside, Noninvasive, and Radiation-Free Imaging for Early Detection of Necrotizing Enterocolitis

Suzanne Al-Hamad

¹Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Maryland

,

David J. Hackam

²Division of Pediatric Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland

,

Seth D. Goldstein

²Division of Pediatric Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland

,

Thierry A. G. M. Huisman

³Division of Pediatric Radiology and Pediatric Neuroradiology, Johns Hopkins Hospital, Baltimore, Maryland

,

Kassa Darge

⁴Division of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

,

Misun Hwang

⁴Division of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

› Author Affiliations

Abstract

Despite extensive research and improvements in the field of neonatal care, the morbidity and mortality associated with necrotizing enterocolitis (NEC) have remained unchanged over the past three decades. Early detection of ischemia and necrotic bowel is vital in improving morbidity and mortality associated with NEC; however, strategies for predicting and preventing NEC are lacking. Contrast-enhanced ultrasound (CEUS) and near-infrared spectroscopy (NIRS) are novel techniques in pediatrics that have been proven as safe modalities. CEUS has benefits over conventional ultrasound (US) by its improved real-time evaluation of the micro- and macrovascularities of normally and abnormally perfused tissue. US has been implemented as a useful adjunct to X-ray for earlier evaluation of NEC. NIRS is another noninvasive technique that has shown promise in improving early detection of NEC. The purpose of this article is to review the current understanding of changes in bowel perfusion in NEC, discuss the accuracy of abdominal US in detecting NEC, and explain how the use of CEUS and NIRS will enhance the precise and early detection of altered/pathological bowel wall perfusion in the initial development and course of NEC.

Keywords

contrast-enhanced ultrasound - CEUS - ultrasound - necrotizing enterocolitis - bowel perfusion - near-infrared spectroscopy - NIRS

Full Text

References

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