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Is "gallbladder length-to-width ratio" useful in diagnosing biliary atresia?
Panjai Choochuen1, Supika Kritsaneepaiboon1, Vorawan Charoonratana1
1Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Thailand.
Journal of Pediatric Surgery
|February 16, 2019
Summary
Ultrasound gallbladder length-to-width ratio (LTWR) can help screen for biliary atresia (BA). Combining LTWR with portal vein and hepatic artery measurements offers high specificity for diagnosing BA.
Area of Science:
- Pediatric Radiology
- Diagnostic Imaging
- Gastroenterology
Background:
- Biliary atresia (BA) diagnosis relies on subjective ultrasound (US) assessments of gallbladder shape and wall.
- Objective assessment of gallbladder parameters is needed to improve BA diagnosis.
Purpose of the Study:
- To evaluate the reliability of gallbladder length-to-width ratio (LTWR) measured by US for diagnosing BA.
Main Methods:
- Retrospective review of transabdominal US findings in 100 infants with conjugated hyperbilirubinemia.
- Analysis of gallbladder lumen, classification, length, width, and LTWR in BA versus non-BA groups.
Main Results:
- Significant differences in gallbladder dimensions and LTWR were observed between BA and non-BA groups (P < 0.05).
- Gallbladder LTWR > 4.1 showed 71.7% sensitivity, while fibrotic cord thickness had 95.9% specificity.
- A combination of portal vein diameter > 4.4 mm, hepatic artery diameter > 1.2 mm, and gallbladder LTWR > 4.1 achieved 98% specificity.
Conclusions:
- Gallbladder LTWR by US is a suggestive parameter for BA screening.
- The combination of portal vein diameter, hepatic artery diameter, and gallbladder LTWR provides the highest diagnostic accuracy for BA.