OBJECTIVEThis 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.

METHODSA 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.

RESULTSRadiographic 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.

CONCLUSIONSThe 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.