Diagnostic Accuracy of Ultrasound in Cholestatic Infants with Biliary Atresia

Area of Science:

• Pediatric Gastroenterology
• Diagnostic Imaging
• Neonatal Medicine

Background:

• Biliary atresia (BA) is a critical obstructive cholangiopathy affecting infants.
• Accurate diagnosis of BA is crucial for timely intervention and improved outcomes.
• Existing research on ultrasound's diagnostic accuracy for BA is primarily from developed nations.

Purpose of the Study:

• To evaluate the diagnostic accuracy of ultrasound (US) in identifying biliary atresia (BA) in infants presenting with cholestasis.
• To assess the utility of specific US findings, such as gallbladder absence and the triangular cord sign, in diagnosing BA.
• To determine the effectiveness of US as a diagnostic tool in a developing country context.

Main Methods:

• Retrospective analysis of hospital medical records for infants with cholestasis.
• Comparison of ultrasound findings with gold standard diagnostic methods (intraoperative cholangiography).
• Inclusion of 35 BA patients and 36 controls, with 85.7% of patients aged ≤ 6 months.

Main Results:

• Absence of gallbladder showed 71.42% sensitivity and 91.67% specificity for BA.
• The triangular cord sign demonstrated 100% specificity but lower sensitivity (14.28%).
• The combination of absent gallbladder and positive triangular cord sign yielded 82.85% sensitivity and 91.67% specificity.

Conclusions:

• Ultrasound demonstrates high diagnostic accuracy for biliary atresia in infants with cholestasis.
• Ultrasound is a valuable, safe, and radiation-free imaging modality for diagnosing BA in daily clinical practice.
• The findings support ultrasound as the preferred initial imaging tool for suspected BA, particularly in resource-limited settings.