Sonographic Findings in a Model of Ischemia-Induced Necrotizing Enterocolitis With Pathological Correlations

Abstract

Purpose: 

To evaluate sonographic findings in ischemic enterocolitis (IEC) and correlate with pathologic findings in an experimental study.

Materials and Methods: 

Ischemic enterocolitis was induced with ligation of the superior mesenteric artery in 20 rabbits. Plain radiography and ultrasonography (US) were performed. US was done hourly after the ligation using 10 MHz linear probe. US findings were categorized into 2 groups according to the bowel wall echogenicity; the echogenic dots (ED) group and the circumferential granular echogenicity (CGE) group. US findings were compared with the specimen radiography and the histopathology.

Results: 

On US, ED were seen in the bowel of all rabbits after SMA ligation (2.2 ± 1.3 hours [standard deviation]) and CGE in 16 rabbits (4.1 ± 0.9 hours). On the specimen radiographs, multiple radiolucent air bubbles were present. Comparing the ED and CGE group, histopathological findings revealed the CGE group had severer injury of the bowel wall than the ED group. On plain radiography, there was progressive bowel distention, but pneumatosis intestinalis (PI) was not evident.

Conclusion: 

ED or CGE are the sonographic findings of ischemic enterocolitis, and bowel wall echogenicity might reflect the degree of ischemic injury.