Necrotizing enterocolitis: diagnosis with CT examination of urine after enteral administration of iodinated water-soluble contrast material.

PURPOSE: To develop a new method for diagnosing necrotizing enterocolitis with use of computed tomography (CT). MATERIALS AND METHODS: Urine specimens from 22 neonates were obtained 8-12 hours after iohexol was administered enterally. Twelve neonates had suspected (n = 5) or definite (n = 7) necrotizing enterocolitis, and 10 neonates without necrotizing enterocolitis underwent routine upper gastrointestinal study. Urine from another 13 neonates without necrotizing enterocolitis who did not receive iohexol was collected. The attenuation coefficient of each urine specimen was determined with CT. RESULTS: The mean CT attenuation coefficient of urine from neonates who did not receive iohexol was 5.6 HU +/- 3.9, and that from neonates without necrotizing enterocolitis who underwent upper gastrointestinal study was 6.7 HU +/- 3.2. The mean CT attenuation coefficient of urine from patients with suspected necrotizing enterocolitis was 26.0 HU +/- 3.4, and that in patients with definite necrotizing enterocolitis was 71.0 HU +/- 18.8. The mean CT attenuation coefficients in neonates with necrotizing enterocolitis were significantly different from that in patients without necrotizing enterocolitis who underwent upper gastrointestinal study. CONCLUSION: Urine from neonates with necrotizing enterocolitis show significantly higher CT attenuation coefficients than those from patients without necrotizing enterocolitis. CT examination of urine may allow early detection of necrotizing enterocolitis.

Article History

Published in print: 1997