Khim, Sim See
(2017)
Ultrasound features in the diagnosis of biliary atresia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Objective: To assess the role of ultrasound (US) in the diagnosis of biliary atresia.
Methodology: Fasting infants with conjugated hyperbilirubinemia were subjected for US
examination in Hospital Sultanah Bahiyah, Kedah. The patients were grouped into biliary atresia
(BA) and non-biliary atresia (non-BA) based on the surgical findings and clinical follow up. The
following features were recorded: tri-angular cord sign, gall bladder morphology, liver size, and
echotexture, splenic size, hepatic artery size, hepatic artery to portal vein ratio, presence of a
common bile duct, and presence of subcapsular flow on colour Doppler. Sensitivity, specificity,
positive and negative predictive values were calculated for each US variable. BA and non-BA
groups were compared by using the Fisher exact test for categorical variables and an unpaired t
test for continues variable.
Results: A total of 82 infants were included in the study; 42 had surgically confirmed BA and 40
had other documented causes of neonatal jaundice. Nine US features showed a significant different
between BA and non-BA group. Ultrasound able to correctly classified 82 infants into BA and
non-BA group with 98% accuracy.
Conclusions: BA can be diagnosed with US from other cause of conjugated hyperbilirubinemia
in 98% of patients if multiple US features are carefully evaluated. These ultrasound variables may
serve as independent predictors of BA.
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