Magnetic resonance imaging of intestinal necrosis in preterm infants

Background and Objective. Noninvasive diagnosis of intestinal necrosis is i mportant in planning surgery in preterm infants with necrotizing enterocoli tis (NEC). We aimed to assess the potential of magnetic resonance imaging ( MRI) for the diagnosis of intestinal necrosis. Study Participants and Methods. Abdominal MRI scans were performed in a gro up of preterm infants with suspected NEC and compared with surgical finding s and to MRI results in a group of control infants. In addition, MRI was pe rformed in 2 preterm infants with suspected NEC who did not require surgery . Results. Six infants with a median birth weight of 1220 g (range, 760-1770 g) and median gestational age at birth of 30 weeks (range, 28-34 weeks) wer e studied at a median postnatal age of 10 days (range, 4-19 days). Four inf ants had a bubble-like appearance in part of the intestinal wall, intramura l gas, and an abnormal fluid level within bowel lumen. At surgery, NEC was found in 5 infants and sigmoid volvulus in 1. The site of the bubblelike ap pearance corresponded to the site of intestinal necrosis at surgery. Four c ontrol infants with a median birth weight of 1500 g (range, 730-2130 g) and a median gestational age of 31 weeks (range, 26-36 weeks) had abdominal MR I at a median postnatal age of 8 days (range, 4-70 days). None of the above findings were seen in any control infant. The bubble-like appearance was n ot seen in the 2 infants with suspected NEC who did not require surgery. Conclusion. Abdominal MRI allows the noninvasive diagnosis of bowel necrosi s. This may aid the timing of surgical intervention in preterm infants with a clinical diagnosis of NEC.