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Early US findings of biliary atresia in infants younger than 30 days
Sook Min Hwang1, Tae Yeon Jeon2, So-Young Yoo1
1Department of Radiology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea, 06351.
Insights
Biliary atresia (BA) diagnosis in infants under 30 days shows atypical ultrasound findings compared to older infants. Gallbladder abnormalities are common, and follow-up ultrasounds may aid diagnosis in young infants.
Area of Science:
- Pediatric imaging
- Hepatobiliary diseases
- Neonatal diagnostics
Background:
- Biliary atresia (BA) is a critical neonatal liver disease.
- Early diagnosis of BA is crucial for effective treatment.
- Ultrasound (US) is a primary diagnostic tool for BA.
Purpose of the Study:
- To compare ultrasound findings for biliary atresia (BA) diagnosis in infants younger than 30 days versus those older than 30 days.
- To identify age-specific US indicators for BA in neonates.
- To evaluate the utility of follow-up US in diagnosing BA in young infants.
Main Methods:
- Retrospective review of hepatobiliary US images from 2000-2015.
- Analysis of 12 BA infants younger than 30 days and 62 BA infants older than 30 days.
- Focus on triangular cord sign, gallbladder (GB) abnormalities, vascular changes, and portal hypertension signs.
Main Results:
- The triangular cord sign was less frequent in infants younger than 30 days (17%) compared to older infants (56%).
- Gallbladder abnormalities were common in both age groups.
- Signs of portal hypertension were significantly less common in younger infants (17%) versus older infants (84%).
- Hepatic artery diameter was smaller in younger BA infants.
Conclusions:
- Infants with BA younger than 30 days exhibit atypical US findings compared to older infants.
- Gallbladder abnormalities are a consistent finding across both age groups.
- Serial US examinations may improve BA detection in neonates.
Purpose:
To investigate and compare ultrasound (US) findings for the diagnosis of biliary atresia (BA) in infants younger than 30 days with those of infants older than 30 days.
Materials And Methods:
From 2000 to 2015, we reviewed hepatobiliary US images in 12 BA infants younger than 30 days (younger BA group) and 62 BA infants older than 30 days (older BA group) before Kasai procedure. Eight (67%) of younger BA group underwent follow-up US examinations before Kasai procedure. Our review of the images focused on triangular cord sign, gallbladder (GB) abnormalities, vascular changes, and signs of portal hypertension.
Results:
The triangular cord sign was present in 17% of younger BA group and in 56% of older BA group (P=.024). GB abnormalities were commonly identified in both groups. The hepatic artery diameter was significantly smaller in younger BA group than in older BA group (P<.001). Signs of portal hypertension were less common in younger BA group (17%) than in older BA group (84%) (P<.001). Follow-up US of two infants in younger BA group showed a new appearance of the triangular cord sign.
Conclusion:
BA infants younger than 30 days showed atypical US findings compared with those older than 30 days.
Key Points:
• BA infants younger than 30 days show atypical US findings. • GB abnormalities were common in both younger and older BA group. • Subsequent US examination may be helpful to diagnose BA in young infants.
