Pneumatosis Plain Film Neonate

Purpose

Identify findings of necrotizing enterocolitis

Tag(s)

 

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 Public Commenting
RadElement Set RDES96
                               

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

  • Normal
  • Paucity of bowel gas
  • Dilated/distended air-filled loops
  • Unknown

Units

N/A


Pneumatosis Detection

RadElement ID

RDE583

Definition

Locules of air within the wall of bowel.

Data Type

Categorical

Value Set

  • Absent
  • Present
  • Unknown

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

  • Absent
  • Present
  • Unknown

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

  • Absent
  • Present
  • Unknown

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)