{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:55:29Z","timestamp":1793912129937,"version":"4.8.0"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003To evaluate the sensitivity and specificity of clinical, laboratory, and radiological markers and the neonatologist-performed intestinal ultrasound (NP-IUS) for treatment interventions in preterm neonates who developed necrotizing enterocolitis (NEC).<\/jats:p><jats:p>\n            Study Design\u2003This was a case\u2013control study of preterm neonates\u2009&lt;\u200935 weeks with a diagnostic workup for NEC. The diagnostic workup included NP-IUS performed by trained neonatologists using a standard protocol, abdominal roentgenogram (AXR), and laboratory investigations. Intestinal ultrasound (IUS) performed by two neonatologists was standardized to detect 11 injury markers. AXRs were read independently by experienced pediatric radiologists. The investigators who retrospectively interpreted the IUS were blinded to the clinical and treatment outcomes.<\/jats:p><jats:p>\n            Results\u2003A total of 111 neonates were assessed. Fifty-four did not require intervention and formed the control group. Twenty cases were treated medically, 21 cases were treated with late surgery for stricture or adhesions, and 16 were treated with early surgery. The integrated model of cumulative severity of ultrasound markers, respiratory and hemodynamic instability, abdominal wall cellulitis, and C- reactive protein\u2009&gt;\u200916\u2009mg\/L had an area under the curve (AUC) of 0.89 (95% confidence interval [CI]: 0.83\u20130.94%, p\u2009&lt;\u20090.0001) for diagnosing NEC requiring surgical intervention. We also investigated the utility of Bell's classification to diagnose either the need for surgery or death, and it had an AUC of 0.74 (95% CI: 0.65\u20130.83%, p\u2009&lt;\u20090.0001).<\/jats:p><jats:p>\n            Conclusion\u2003In this cohort, a combination of specific IUS markers and clinical signs of instability, abdominal wall cellulitis, plus laboratory markers were diagnostic of NEC requiring interventions.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0043-1778666","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:14:13Z","timestamp":1705018453000},"page":"e3401-e3412","source":"Crossref","is-referenced-by-count":4,"special_numbering":"S","title":["A Novel Integrated Clinical\u2013Biochemical\u2013Radiological and Sonographic Classification of Necrotizing Enterocolitis"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7989-0285","authenticated-orcid":false,"given":"Yasser","family":"Elsayed","sequence":"additional","affiliation":[{"name":"Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8535-4208","authenticated-orcid":false,"given":"Deepak","family":"Louis","sequence":"additional","affiliation":[{"name":"Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Hinton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Biology of Breathing Theme, Children's Hospital Research Institute of Manitoba, Manitoba, Winnipeg, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Seshia","sequence":"additional","affiliation":[{"name":"Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben","family":"Alvaro","sequence":"additional","affiliation":[{"name":"Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyamala","family":"Dakshinamurti","sequence":"additional","affiliation":[{"name":"Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada"},{"name":"Department of Pediatrics, Biology of Breathing Theme, Children's Hospital Research Institute of Manitoba, Manitoba, Winnipeg, 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