Value of color Doppler ultrasonography in the differential diagnosis of cystic biliary atresia and choledochal cyst in infants

doi:10.3877/cma.j.issn.2095-3232.2015.02.011

Abstract

Abstract:

Objective

To explore the value of color Doppler ultrasonography (CDU) in the differential diagnosis of cystic biliary atresia (CBA) and choledochal cyst (CC) in infants.

Methods

A total of 54 infants diagnosed with hepatic portal cystic lesion in the First Affiliated Hospital of Sun Yat-sen University from January 2012 to July 2014 who were going to receive surgical treatment were included in this prospective study. Of the 54 cases, 35 were baby boys and 19 were baby girls with a mean of (63±19) d old. According to the results of pathological examination, the patients were divided into the CBA group and the CC group. All guardians of the infants signed the informed consent and the local ethical committee approval had been received. Preoperative TB level and DB level were recorded. CDU was used to observe the incidence of hepatic portal fibrous mass, intrahepatic bile duct dilation and biliary sludge sedimentation in the cyst. In addition, the length diameter and width diameter of gallbladder and the inner diameter of hepatic artery were measured. The observed parameters of two groups were compared by χ² test or t test.

Results

The incidence of hepatic portal fibrous mass in CBA group was 96% (25/26), which was significantly higher than 0 (0/28) in CC group (P<0.05). The incidence of intrahepatic bile duct dilation and biliary sludge sedimentation in the cyst in CBA group were both 0 (0/26), which were significantly lower than 75% (21/28) and 54% (15/28) in CC group (P<0.05). The width diameter of gallbladder in CBA group was (5±1) mm, which was significantly less than (8±2) mm in CC group (t=-38.68, P<0.05). The inner diameter of hepatic artery in CBA group was (2.4±0.4) mm, which was significantly greater than (1.8±0.3) mm in CC group (t=28.40, P<0.05).

Conclusions

The hepatic portal fibrous mass, intrahepatic bile duct dilation, biliary sludge sedimentation in the cyst, width diameter of gallbladder and inner diameter of hepatic artery are effective indexes for CDU to differentiate CBA and CC, thus, CDU may be used in the preoperative differential diagnosis.

Key words: Ultrasonography, Biliary atresia, Choledochal cyst, Jaundice, neonatal

Quanyuan Shan, Xiuying Cai, Hong Jiang, Luyao Zhou, Wei Wang, Xiaoer Zhang, Juncheng Liu, Wenjie Chen, Xiaoyan Xie. Value of color Doppler ultrasonography in the differential diagnosis of cystic biliary atresia and choledochal cyst in infants[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2015, 04(02): 105-108.

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References 18

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组别	例数	年龄（d，±s）	性别（例）		TB(μmol/L，±s)	DB(μmol/L，±s)
组别	例数	年龄（d，±s）	男	女	TB(μmol/L，±s)	DB(μmol/L，±s)
CBA	26	69±15	17	9	182±32	135±23
CC	28	66±21	18	10	173±47	119±31
统计值	?	t=0.151	χ² =0.394		t=0.536	t=0.271
P值	?	>0.05	>0.05		>0.05	>0.05

组别	例数	年龄（d，±s）	性别（例）		TB(μmol/L，±s)	DB(μmol/L，±s)
组别	例数	年龄（d，±s）	男	女	TB(μmol/L，±s)	DB(μmol/L，±s)
CBA	26	69±15	17	9	182±32	135±23
CC	28	66±21	18	10	173±47	119±31
统计值	?	t=0.151	χ² =0.394		t=0.536	t=0.271
P值	?	>0.05	>0.05		>0.05	>0.05

组别	例数	肝门部纤维块		肝内胆管扩张		囊肿内胆泥沉积		胆囊大小(mm，±s)		肝动脉内径(mm，±s)
组别	例数	无	有	无	有	无	有	长径	宽径	肝动脉内径(mm，±s)
CBA	26	1	25	26	0	26	0	28±11	5±1	2.4±0.4
CC	28	28	0	7	21	13	15	27±11	8±2	1.8±0.3
统计值	?	-		-		-		t=0.52	t=-38.68	t=28.40
P值	?	<0.05		<0.05		<0.05		>0.05	<0.05	<0.05

组别	例数	肝门部纤维块		肝内胆管扩张		囊肿内胆泥沉积		胆囊大小(mm，±s)		肝动脉内径(mm，±s)
组别	例数	无	有	无	有	无	有	长径	宽径	肝动脉内径(mm，±s)
CBA	26	1	25	26	0	26	0	28±11	5±1	2.4±0.4
CC	28	28	0	7	21	13	15	27±11	8±2	1.8±0.3
统计值	?	-		-		-		t=0.52	t=-38.68	t=28.40
P值	?	<0.05		<0.05		<0.05		>0.05	<0.05	<0.05

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