Pneumatosis Plain Film Neonate
| Purpose | Identify findings of necrotizing enterocolitis |
| Tag(s) |
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| Panel | Pediatric Panel |
| Define-AI ID | 19010002 |
| Originator | Alex Towbin |
| Lead | Alex Towbin |
| Panel Chair | Matt Hawkins |
| Panel Reviewers | Pediatric Panel |
| License | Creative Commons 4.0 |
| Status | Published |
Clinical Implementation
Value Proposition
Necrotizing enterocolitis (NEC) is the most common gastrointestinal disease of newborns. It typically affects premature infants and can be devastating leading to strictures, bowel perforations, bowel necrosis, and even death. Affected patients can present with a number of different clinical findings including abdominal distension, bilious aspirate from a nasogastric tube, increased aspirates from a nasogastric tube, abdominal discoloration, bloody stool, decreased bowel sounds, apnea, temperature instability, and shock. An abdominal radiograph is often used to identify patients with necrotizing enterocolitis. Findings on abdominal radiographs include dilated air-filled loops of bowel, pneumatosis intestinalis, portal venous gas, and intraperitoneal free air. Automated detection of the early findings of NEC will allow neonatologists to begin treatment earlier.Narrative(s)
An abdominal radiograph is ordered for a premature infant with abdominal distension, bloody stool, and bilious aspirates.Workflow Description
An abdominal radiograph performed in an infant in the first two months of life.An abdominal radiograph is taken and sent to PACS and the AI engine. The algorithm identifies the bowel gas pattern and then detects if pneumatosis, portal venous gas, and/or intraperitoneal free air is present or absent.
Considerations for Dataset Development
| Procedures | Radiograph abdomen |
| Age | [0-2 months] |
| In-Patient Location | NICU |
| Positioning | AP Supine, Cross-table lateral |
Technical Specifications
Inputs
DICOM Study
| Procedure | Abdominal radiograph |
| Views | AP Supine, cross-table lateral |
| Data Type | DICOM |
| Modality | Radiograph |
| Body Region | Abdomen |
| Anatomic Focus | Bowel, Liver |
Primary Outputs
Bowel Gas Pattern
| RadElement ID | RDE582 |
| Definition | Description of the pattern of air in loops of bowel |
| Data Type | Categorical |
| Value Set |
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| Units | N/A |
Pneumatosis Detection
| RadElement ID | RDE583 |
| Definition | Locules of air within the wall of bowel. |
| Data Type | Categorical |
| Value Set |
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| Units | N/A |
Portal Venous Gas Detection
| RadElement ID | RDE584 |
| Definition | Air within the portal vein and intrahepatic portal venous system |
| Data Type | Categorical |
| Value Set |
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| Units | N/A |
Intraperitoneal free air detection
| RadElement ID | RDE585 |
| Definition | Air within the abdomen, outside of loops of bowel |
| Data Type | Categorical |
| Value Set |
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| Units | N/A |
Future Development Ideas
- Identify patients at risk for NEC or based on laboratory findings or other risk factors
- Identify patients at risk for developing surgical NEC (free air)