Radiographic predictors determined with an objective assessment tool for neonatal patients with necrotizing enterocolitis
Journal Title: Jornal de Pediatria - Year 2019, Vol 95, Issue 6
Abstract
Objective The objective of this study was to develop and validate a computational tool to assist radiological decisions on necrotizing enterocolitis. Methodology Patients that exhibited clinical signs and radiographic evidence of Bell's stage 2 or higher were included in the study, resulting in 64 exams. The tool was used to classify localized bowel wall thickening and intestinal pneumatosis using full-width at half-maximum measurements and texture analyses based on wavelet energy decomposition. Radiological findings of suspicious bowel wall thickening and intestinal pneumatosis loops were confirmed by both patient surgery and histopathological analysis. Two experienced radiologists selected an involved bowel and a normal bowel in the same radiography. The full-width at half-maximum and wavelet-based texture feature were then calculated and compared using the Mann–Whitney U test. Specificity, sensibility, positive and negative predictive values were calculated. Results The full-width at half-maximum results were significantly different between normal and distended loops (median of 10.30 and 15.13, respectively). Horizontal, vertical, and diagonal wavelet energy measurements were evaluated at eight levels of decomposition. Levels 7 and 8 in the horizontal direction presented significant differences. For level 7, median was 0.034 and 0.088 for normal and intestinal pneumatosis groups, respectively, and for level 8 median was 0.19 and 0.34, respectively. Conclusions The developed tool could detect differences in radiographic findings of bowel wall thickening and IP that are difficult to diagnose, demonstrating the its potential in clinical routine. The tool that was developed in the present study may help physicians to investigate suspicious bowel loops, thereby considerably improving diagnosis and clinical decisions.
Authors and Affiliations
Diana de Pina
Keywords
Related Articles
- EP ID EP664340
- DOI 10.1016/j.jped.2018.05.017
- Views 104
- Downloads 0
Atypical manifestations of Epstein–Barr virus in children: a diagnostic challenge
Objective Clarify the frequency and the pathophysiological mechanisms of the rare manifestations of Epstein–Barr virus infection. Sources Original research studies published in English between 1985 and 2015 were selecte...
Association between postpartum depression and the practice of exclusive breastfeeding in the first three months of life
Objective To investigate the association between postpartum depression and the occurrence of exclusive breastfeeding. Method This is a cross-sectional study conducted in the states of the Northeast region, during the va...
Tongue development in stillborns autopsied at different gestational ages
Objectives This study aimed to analyze, through the morphometric method, the perimeter and length of the tongue, the collagen fibers, and the perimeter of blood vessels at different gestational ages and fetal weights. M...
Association between nutritional status and outcomes in critically-ill pediatric patients – a systematic review
Objectives To systematically review the evidence about the impact of nutritional status in critically-ill pediatric patients on the following outcomes during hospitalization in pediatric intensive care units: length of h...
Evaluation of clinical and laboratory variables associated with anemia in pediatric patients on hemodialysis
Objective To identify the occurrence of anemia in pediatric patients on hemodialysis and the association between hemoglobin levels and anemia in CKD-related variables. Methods This was a retrospective study. Patients ag...