Hepatic Arterial Diameter Measured with US: Adjunct for US Diagnosis of Biliary Atresia
- 1 November 2007
- journal article
- research article
- Published by Radiological Society of North America (RSNA) in Radiology
- Vol. 245 (2), 549-555
- https://doi.org/10.1148/radiol.2452061093
Abstract
To prospectively evaluate the accuracy of hepatic artery diameter and hepatic artery diameter-to-portal vein diameter ratio for ultrasonographic (US) diagnosis of biliary atresia, with cholangiographic or clinical information as reference standard. Institutional review board approval and informed consent were obtained. US was performed in 68 neonates and infants with cholestatic jaundice (mean age, 61 days; male-to-female ratio, 38:30). Biliary atresia (n = 38) was confirmed with cholangiography, and hepatitis (n = 30) was diagnosed with clinical (n = 24) or cholangiographic (n = 6) findings. Diameter of the right hepatic artery was measured with US. Right hepatic artery diameter-to-right portal vein diameter ratio was measured to determine relative enlargement of the hepatic artery. As a control group, 17 neonates and infants (mean age, 67 days; male-to-female ratio, 12:5) without jaundice underwent US of the porta hepatis. Statistical analysis was performed to compare US parameters among three groups with one-way analysis of variance. Optimal cutoff values of the hepatic artery diameter and hepatic artery diameter-to-portal vein diameter ratio for biliary atresia diagnosis were obtained with receiver operating characteristic analysis. The diameter of the right hepatic artery in biliary atresia group (1.9 mm +/- 0.4 [standard deviation]) was significantly larger than that in the hepatitis (1.4 mm +/- 0.3) and control (1.2 mm +/- 0.2) groups (P < .001). Hepatic artery diameter-to-portal vein diameter ratio in the biliary atresia group (0.52 +/- 0.12) was larger than that in hepatitis (0.40 +/- 0.07) and in control (0.40 +/- 0.10) groups (P < .001). Optimum cutoff values for diagnosis of biliary atresia were 1.5 mm (sensitivity, 92%; specificity, 87%; accuracy, 89%) for hepatic artery diameter and 0.45 for hepatic artery diameter-to-portal vein diameter ratio (sensitivity, 76%; specificity, 79%; accuracy, 78%). Measurement of hepatic artery diameter can be helpful in the US diagnosis of biliary atresia.This publication has 23 references indexed in Scilit:
- Objective Criteria of Triangular Cord Sign in Biliary Atresia on US ScansRadiology, 2003
- Biliary atresia: making the diagnosis by the gallbladder ghost triadPediatric Radiology, 2003
- Gallbladder contraction in biliary atresia: a pitfall of ultrasound diagnosisPediatric Radiology, 1998
- Comparison technetium of Tc-99m disofenin cholescintigraphy with ultrasonography in the differentiation of biliary atresia from other forms of neonatal jaundicePediatric Surgery International, 1997
- Biliary atresia: Current concepts and research directions. Summary of a symposiumJournal of Hepatology, 1996
- ‘Triangular cord’: A sonographic finding applicable in the diagnosis of biliary atresiaJournal of Pediatric Surgery, 1996
- Long-term follow-up after surgery for patients with biliary atresiaJournal of Pediatric Surgery, 1990
- An imaging approach to persistent neonatal jaundiceAmerican Journal of Roentgenology, 1984
- Diagnosis of biliary atresia with radionuclide hepatobiliary imaging.Radiology, 1983
- Technique and results of operative management of biliary atresiaWorld Journal of Surgery, 1978