Highlights
- •MRI image can give more information for diagnosis of biliary atresia when other image findings are inconclusive.
- •Enlarged T2-weighted high signal at porta hepatis can distinguish biliary atresia from neonatal hepatitis.
- •A quantitative measurement in the MRI image may be helpful for diagnosis of biliary atresia.
Abstract
Purpose
Biliary atresia is a life-threatening disease that needs early diagnosis and management.
Recently, MRI images have been used for the diagnosis of biliary atresia with improved
accuracy of diagnosis when other imaging modalities such as ultrasonography are equivocal.
This study aimed to evaluate the juxta-hilar extrahepatic biliary tree using MRI images
to determine a quantitative value for diagnosing biliary atresia.
Materials and methods
This retrospective study was approved by the Ethical Committee at Mackey Memorial
Hospital (IRB Number: 15MMHIS149e). Between January 2010 and December 2015, twenty-five
patients with surgically confirmed biliary atresia were enrolled (age 18–65 days).
Another 25 patients with clinically or surgically diagnosed idiopathic neonatal hepatitis
(age 6–64 days) and 20 patients with non-hepatobiliary disease (age 6–65 days) were
considered control group and normal subjects, respectively. The diameter of the enlarged,
T2-hyperintense structure was measured using MRI images by two radiologists both blinded.
The cut-off value for a biliary atresia diagnosis was obtained by area under the curve
analysis.
Results
The diameter of the T2-hyperintense structure at porta hepatis in biliary atresia
(4.79 ± 1.14 mm) is larger than in idiopathic neonatal hepatitis (1.72 ± 0.42 mm)
or in non-hepatobiliary disease (1.72 ± 0.35 mm) (p < 0.05). The optimum cut-off value
for diagnosing biliary atresia was 3.1 mm with 98% sensitivity and 98% specificity.
Conclusion
The value of the enlarged, T2-hyperintense structure measured on MRI images was significantly
increased in biliary atresia and may be useful in diagnosing biliary atresia.
Keywords
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Article Info
Publication History
Published online: October 11, 2018
Accepted:
October 1,
2018
Received in revised form:
September 17,
2018
Received:
May 14,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
