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World J Gastroenterol. Jun 14, 2008; 14(22): 3579-3582
Published online Jun 14, 2008. doi: 10.3748/wjg.14.3579
Ultrasonic diagnosis of biliary atresia: A retrospective analysis of 20 patients
Shi-Xing Li, Yao Zhang, Mei Sun, Bo Shi, Zhong-Yi Xu, Ying Huang, Zhi-Qin Mao
Shi-Xing Li, Yao Zhang, Bo Shi, Zhong-Yi Xu, Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Mei Sun, Zhi-Qin Mao, Department of Internal Medicine for Childhood, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Ying Huang, Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Li SX, Sun M, and Zhang Y contributed equally to this work; Li SX, Sun M, Shi B, and Xu ZY designed the research; Li SX, Mao ZQ analyzed the data; Li SX, Sun M, and Huang Y performed the research; Li SX and Zhang Y provided the analytic tools; Li SX, Sun M, and Zhang Y wrote the paper.
Correspondence to: Mei Sun, Department of Internal Medicine for Childhood, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. lisx630106@vip.sina.com
Telephone: +86-24-83956537
Fax: +86-24-83955092
Received: December 12, 2007
Revised: March 12, 2008
Accepted: March 19, 2008
Published online: June 14, 2008
Abstract

AIM: To investigate the clinical value of ultrasonographic diagnosis of biliary atresia (BA), a retrospective analysis of the sonogram of 20 children with BA was undertaken.

METHODS: Ultrasonography (US) was performed in 20 neonates and infants with BA, which was confirmed with cholangiography by operation or abdominoscopy. The presence of triangular cord, the size and echo of liver, the changes in empty stomach gallbladder and postprandial gallbladder were observed and recorded.

RESULTS: The triangular cord could be observed at the porta hepatis (thickness: 0.3-0.6 cm) in 10 cases. Smaller triangular cord (0.2-0.26 cm) can be observed in 3 cases. The gallbladder was not observed in 2 cases, and 1 case showed a streak gallbladder without capsular space. The gallbladders of 15 cases were flat and small. The gallbladders of 2 cases were of normal size and appearance, however, there was no postprandial contraction. The livers of all cases showed hepatomegaly and heterogeneous echogenicity. Statistical analysis was performed to compare the hepatomegaly and heterogeneous echogenicity and the stage of hepatic fibrosis.

CONCLUSION: The presence of the triangular cord at the porta hepatis is specific. However, it is not the only diagnostic criterion, since flat and small gallbladder and poor contraction are also of important diagnostic and differential diagnostic significance. The degree of hepatomegaly and heterogeneous echogenicity is proportional with liver fibrosis, and able to indicate the duration of course and prognosis.

Keywords: Biliary atresia; Ultrasonic diagnosis; The triangular cord; Maldevelopment of gallbladder; Magnetic resonance imaging