Key imaging features for differentiating cystic biliary atresia from choledochal cyst: prenatal ultrasonography and postnatal ultrasonography and MRI
Hyun Joo Shin1,2 , Haesung Yoon1,2 , Seok Joo Han2,3,4 , Kyong Ihn2,3,4 , Hong Koh2,5 , Ja-Young Kwon6 , Mi-Jung Lee1,2
1Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Seoul, Korea
2Severance Pediatric Liver Disease Research Group, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
3Department of Pediatric Surgery, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
4Department of Surgery, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
5Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
6Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
Corresponding Author: Mi-Jung Lee ,Tel: +82-2-2228-7400, Fax: +82-2-2227-8337, Email: mjl1213@yuhs.ac
Received: April 28, 2020;  Accepted: July 31, 2020.  Published online: July 31, 2020.
ABSTRACT
Purpose:
This study compared clinical and radiologic differences between cystic biliary atresia (cBA) and choledochal cyst (CC) type Ia/b.
Methods:
Infants (≤12 months old) who were diagnosed with cBA or CC type Ia/b from 2005 to 2019 were retrospectively reviewed. Imaging features on preoperative ultrasonography (US) and magnetic resonance imaging (MRI) were compared between the cBA and CC groups. Logistic regression and area under the receiver operating characteristic curve (AUC) analyses were performed for the diagnosis of cBA. Changes in cyst size were also evaluated when prenatal US exams were available.
Results:
Ten patients (5.5% of biliary atresia cases) with cBA (median age, 48 days) and 11 infants with CC type Ia/b (Ia:Ib=10:1; median age, 20 days) were included. Triangular cord thickness on US (cutoff, 4 mm) showed 100% sensitivity and 90.9% specificity (AUC, 0.964; 95% confidence interval [CI], 0.779 to 1.000) and cyst size on MRI (cutoff, 2.2 cm) had 70% sensitivity and 100% specificity (AUC, 0.900; 95% CI, 0.690 to 0.987) for diagnosing cBA. Gallbladder mucosal irregularity on US and an invisible distal common bile duct on MRI were only seen in the cBA group (10 of 10). Only the CC group showed prenatal cysts exceeding 1 cm with postnatal enlargement.
Conclusion:
Small cyst size (<1 cm) on prenatal US, triangular cord thickening (≥4 mm) and gallbladder mucosal irregularity on postnatal US, and small cyst size (≤2.2 cm) and an invisible distal common bile duct on MRI can discriminate cBA from CC type Ia/b in infancy.
Keywords: Biliary atresia; Choledochal cyst; Neonatal jaundice; Ultrasonography; Magnetic resonance imaging
TOOLS
METRICS
0
Crossref
333
View
13
Download
We recommend
Editorial Office
A-304 Mapo Trapalace, 53 Mapo-daero, Mapo-gu, Seoul 04158, Korea
TEL : +82-2-763-5627   FAX : +82-2-763-6909   E-mail : office@ultrasound.or.kr
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
Copyright © Korean Society of Ultrasound in Medicine. All rights reserved.                 powerd by m2community
Close layer
prev next