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Ultrasound features of the gall bladder in infants presenting with conjugated hyperbilirubinaemia

P Farrant1, H B Meire, G Mieli-Vergani

  • 1Variety Club Children's Hospital, King's College Hospital, Denmark Hill, London SE5 9RS, UK.

The British Journal of Radiology
|January 6, 2001
PubMed

Insights

Ultrasound can identify biliary atresia in infants by examining gallbladder shape and wall structure. Abnormalities detected via ultrasound show high accuracy in diagnosing this serious liver condition.

Area of Science:

  • Pediatric Gastroenterology
  • Diagnostic Imaging
  • Neonatal Hepatology

Background:

  • Biliary atresia is a severe neonatal liver disease requiring early diagnosis.
  • Ultrasound is a primary imaging modality for evaluating infantile cholestasis.
  • Previous studies suggested potential ultrasound markers for biliary atresia.

Purpose of the Study:

  • To prospectively evaluate the diagnostic performance of gallbladder ultrasound findings in infants with conjugated hyperbilirubinemia.
  • To determine the sensitivity, specificity, and accuracy of ultrasound in identifying biliary atresia.

Main Methods:

  • Prospective ultrasound study of 346 infants (≤12 weeks) with conjugated hyperbilirubinemia.
  • Assessment of gallbladder visualization, shape, and wall regularity.
  • Correlation of ultrasound findings with confirmed biliary atresia diagnosis.

Main Results:

  • Gallbladder was visualized in 331 infants; 60/331 had biliary atresia.
  • Absent gallbladder was seen in 11/15 infants with biliary atresia.
  • Irregular gallbladder shape and wall structure were significantly associated with biliary atresia, yielding high diagnostic accuracy (91.9%).

Conclusions:

  • Ultrasound assessment of gallbladder morphology is a valuable, non-invasive tool for diagnosing biliary atresia in infants.
  • Specific ultrasound findings, including absence, irregular shape, and irregular wall, significantly increase the likelihood of biliary atresia.
  • High sensitivity (90%) and specificity (92.4%) support the use of ultrasound as a key diagnostic step.

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