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Color doppler sonography speeds detection of serious illness in premature infants

OAK BROOK, Ill. Measuring blood flow to a newborn's intestines using a special form of ultrasound can help radiologists identify a life-threatening complication in a serious bowel disease, according to a study in the May issue of the journal Radiology.

Necrotizing enterocolitis (NEC) is an acquired inflammatory gastrointestinal disease of unknown cause. It is the most common and serious gastrointestinal disorder among hospitalized premature babies, according to the Nemours Foundation. Symptoms include the inability to feed, abdominal bloating and difficulty emptying the stomach. The small and large intestine may cease to function properly and parts of the intestine can die, possibly leading to bowel perforation and death.

"The prognosis for NEC worsens once bowel perforation occurs," said the study's lead author, Ricardo Faingold, M.D., currently an assistant professor of radiology at McGill University in Montreal. "Earlier detection of necrotic or dead bowel in NEC will improve an infant's chance for survival."

From 2000 to 2002, Dr. Faingold and colleagues at the University of Toronto used color Doppler sonography to examine 30 premature and full-term infants with suspected or proven NEC.

Researchers then compared the CDS findings with those from abdominal x-rays. CDS uses high-frequency sound waves to detect and quantify blood flow. When x-rays are used to diagnose dead bowel in NEC, doctors are looking for perforations in the intestine or gas in the abdomen that escapes from these holes. The study results indicated that CDS was more sensitive and specific than x-ray for determining NEC in newborns.

"It's a very simple idea," Dr. Faingold said. "If there is blood flow to the wall of the intestine, that's a good sign. If there is no blood flow, that's bad. It means that particular area of the intestine is dying or is dead. When you see free gas in the x-ray, it may be too late. The babies are very sick by then."
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Contact: Doug Dusik
ddusik@rsna.org
630-590-7762
Radiological Society of North America
26-Apr-2005


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