Objective: This study was conducted to determine the value of the radiographic assessment scale in the diagnosis of neonatal necrotizing enterocolitis, and as measured by need for surgery.
Methods: A total of 61 neonates were classified into three groups according to the Bell's Staging Criteria: NECⅠ(n=25), NECⅡ(n=11) and NEC Ⅲ(n=25). Data on gestational age at birth, gender, birth weight, clinical manifestations, treatment and prognosis of the patients were collected. Radiographic assessment scale scores were evaluated by a pediatric radiologist.
Results: Radiographic assessment scale scores in the NECⅠ, NECⅡand NEC Ⅲ groups were 3.2±1.4, 5.3±1.7 and 8.9±1.7, respectively (P<0.05). The score was highest in the NEC Ⅲ group and lowest in the NECⅠgroup. Based on the different therapies, the NEC Ⅲ group was subdivided into operative and non-operative groups. Radiographic assessment scale scores in the two subgroups were 8.71±1.86 and 9.36±1.21 respectively (P>0.05). Radiographic assessment scale scores in neonates with intestinal perforation (9.6±1.1) were higher than in those with intestinal necrosis (6.8±1.8) (P<0.05). The majority of patients (80%) who underwent operation had radiographic assessment scale scores above 7. The effective rate was 96% and 64% respectively in the NECⅠand the NECⅡ groups. Of the children in the NECⅢ group, the cure rate was 71% in the operative group, and the effective rate was 9% in the non-operative group.
Conclusions: The radiographic assessment scale may be used to evaluate the severity of disease in neonates with NEC. Patients with a score on the radiographic assessment scale above 7 have indications for surgical intervention and have better short-term treatment response rates.