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The triangular cord ratio and the presence of a cystic lesion in the triangular cord. Suggested new ultrasound findings in the early diagnosis of Biliary Atresia
Ist Teil von
Pediatric surgery international, 2021-12, Vol.37 (12), p.1693-1697
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2021
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
Background
In biliary atresia (BA), the ultrasonic triangular cord (TC) sign is positive at ≥ 3 mm, but sometimes there is BA even if it is ≤ 3 mm. For improving the ultrasonographic diagnosis, we have established a new evaluation, adding the ratio of the anterior/posterior thickness (TC ratio) in the hyperechoic area and the presence of a cystic lesion in the triangular cord (TCC).
Methods
We examined 24 cases of suspected BA who demonstrated acholic stools from 2006 to 2020. We retrospectively reviewed the timing of ultrasonographic diagnosis, the gallbladder diameter, gallbladder mucosal irregularity, the TC sign, TCC, and the TC ratio.
Results
In the BA group (
n
= 10) vs the Non-BA group (
n
= 14), the age at ultrasonography was 75 ± 41.7 vs. 81 ± 39.1 days (
p
= 0.72), the gallbladder diameter was 12.1 ± 9.7 vs. 24.2 ± 6.96 mm (
p
= 0.02), irregularity of gallbladder mucosa was 7 cases vs. 1 case (
p
< 0.01), and TC sign was 3.9 ± 1.3 vs. 2.0 ± 0.49 mm (
p
= 0.01), respectively. TCC was observed in 8/10 cases in the BA group and none in the Non-BA group (
p
< 0.01). TC ratio was 3.40 ± 0.68 (BA group) and 1.59 ± 0.41 (Non-BA group) (
p
< 0.01).
Conclusion
The ultrasonic TC ratio improves the diagnostic accuracy of BA. TCC is a specific finding in the BA group.