The porta hepatis microcyst: an additional sonographic sign for the diagnosis of biliary atresia.

Details

Serval ID
serval:BIB_275CF5C2472F
Type
Article: article from journal or magazin.
Collection
Publications
Title
The porta hepatis microcyst: an additional sonographic sign for the diagnosis of biliary atresia.
Journal
European radiology
Author(s)
Koob M., Pariente D., Habes D., Ducot B., Adamsbaum C., Franchi-Abella S.
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Publication state
Published
Issued date
05/2017
Peer-reviewed
Oui
Volume
27
Number
5
Pages
1812-1821
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To describe and evaluate an additional sonographic sign in the diagnosis of biliary atresia (BA), the microcyst of the porta hepatis, in comparison with previously described signs.
Ultrasound performed in 321 infants (mean age 55 days) with cholestasis were retrospectively analyzed. BA was surgically confirmed in 193 patients and excluded in 128. US evaluated gallbladder type (1: normal; 2: consistent with BA; 3: suspicious), triangular cord sign (TCS), microcyst and macrocyst, polysplenia syndrome, portal hypertension, and bile duct dilatation. T test and Pearson χ(2) test were used to compare US signs between the two groups, followed by univariate regression analysis.
The highest specificity and sensitivity for BA (p < 0.001) were respectively obtained with non-visible gallbladder (100 %-13 %), macrocyst (99 %-10 %), polysplenia (99 %-11 %), microcyst (98 %-20 %), type 2 gallbladder (98 %-34 %), and TCS (97 %-30 %). Combination of signs (macro or microcyst; cyst and no bile duct dilatation; microcyst and/or TCS; type 2 gallbladder and/or cyst) provided better sensitivities (25-49 %) with similar specificities (95-98 %) (p < 0.001). On univariate analysis, the single US signs most strongly associated with BA were polysplenia (odds ratio, OR 16.3), macrocyst (OR 14.7), TCS (OR 13.4) and microcyst (OR 8).
Porta hepatis microcyst is a reliable US sign for BA diagnosis.
• The porta hepatis microcyst is a specific sign of biliary atresia. • It was found in 31 (16.1 %) of 193 patients with biliary atresia. • Its specificity was 98 % (p < 0.001). • High frequency transducer and color Doppler can show the porta hepatis microcyst.

Keywords
Bile Duct Diseases/complications, Bile Duct Diseases/diagnostic imaging, Biliary Atresia/complications, Biliary Atresia/diagnostic imaging, Cholestasis/complications, Cholestasis/diagnostic imaging, Cysts/complications, Cysts/diagnostic imaging, Dilatation, Pathologic/complications, Dilatation, Pathologic/diagnostic imaging, Female, Gallbladder/diagnostic imaging, Heterotaxy Syndrome/complications, Heterotaxy Syndrome/diagnostic imaging, Humans, Hypertension, Portal/complications, Hypertension, Portal/diagnostic imaging, Infant, Infant, Newborn, Liver/diagnostic imaging, Male, Retrospective Studies, Sensitivity and Specificity, Ultrasonography, Biliary atresia, Cyst, Gallbladder, Triangular cord sign, Ultrasound
Pubmed
Web of science
Create date
28/08/2017 14:11
Last modification date
20/08/2019 13:06
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