Enlarged hepatic hilar lymph node: an additional ultrasonographic feature that may be helpful in the diagnosis of biliary atresia

Weng, Zongjie; Zhou, Luyao; Wu, Qiumei; Zhou, Wenying; Ma, Hong; Fang, Yifan; Dang, Tingting; Liu, Min

doi:10.1007/s00330-019-06339-w

Cited by 12 publications

(12 citation statements)

References 18 publications

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“…As previously reported, the combination of TC sign and gallbladder abnormalities could yield a sensitivity of 96.9% and specificity of 86.1% 21 . However, some BA infants presented normal gallbladder and negative TC sign, and BA could not be detected by US 21,23,24 . For BA infants who present negative US findings, GGT levels may be a complementary indicator to improve the diagnosis of BA.…”

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confidence: 75%

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Gamma‐Glutamyl Transferase Combined With Conventional Ultrasound Features in Diagnosing Biliary Atresia

Weng

Zhou

et al. 2022

J of Ultrasound Medicine

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Objectives To develop and validate a biliary atresia (BA) diagnostic score based on serum gamma‐glutamyl transferase (GGT) levels and conventional ultrasound features for discriminating BA in patients with jaundice from two centers. Methods A total of 958 patients from one hospital were classified as the derivation cohort, and 725 patients from another hospital were classified as the validation cohort. The optimal GGT cutoff value for diagnosing BA was calculated in the derivation cohort and subsequently verified in the validation cohort. Gallbladder abnormalities and the triangular cord (TC) sign were evaluated in all patients. A BA diagnostic score was developed for diagnosing BA using the GGT levels, gallbladder abnormalities and the TC sign based on the data from the derivation cohort followed by external validation. Results Based on the optimal cutoff value 350.0 U/L, GGT yielded a sensitivity of 59.3% and specificity of 85.4% in diagnosing BA. The area under the receiver operating characteristic curve (AUC 0.724) was inferior to that of the gallbladder (AUC 0.911, P < .001) and comparable to that of the TC sign (AUC 0.771, P = .128). The combination of GGT and ultrasound diagnosis could help to reduce the misdiagnosis of 9 infants with BA. The BA diagnostic score yielded a sensitivity of 93.3% and specificity of 95.0% with the highest AUC in this study (0.941). Conclusions GGT can add diagnostic value to ultrasound examination when diagnosing BA. The BA diagnostic score based on GGT, gallbladder abnormalities and the TC sign shows satisfactory discrimination abilities in BA.

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confidence: 75%

“…21 However, some BA infants presented normal gallbladder and negative TC sign, and BA could not be detected by US. 21,23,24 For BA infants who present negative US findings, GGT levels may be a complementary indicator to improve the diagnosis of BA.…”

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confidence: 99%

Gamma‐Glutamyl Transferase Combined With Conventional Ultrasound Features in Diagnosing Biliary Atresia

Weng

Zhou

et al. 2022

J of Ultrasound Medicine

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“…On the other hand, patients with a thickness value less than 2 mm ( Figure 2 d) were deemed as without BA. The diagnostic performance of this modified TC sign could be comparable or superior to that of the gallbladder abnormalities, with the areas under the receiver operating characteristic curve (AUC) ranged from 0.771 to 0.952 [ 20 , 21 , 27 , 28 ]. Higher AUC could be obtained when modified TC thickness combined with the gallbladder abnormalities [ 20 , 21 , 27 , 28 ].…”

Section: Conventional Ultrasoundmentioning

confidence: 99%

“…The diagnostic performance of this modified TC sign could be comparable or superior to that of the gallbladder abnormalities, with the areas under the receiver operating characteristic curve (AUC) ranged from 0.771 to 0.952 [ 20 , 21 , 27 , 28 ]. Higher AUC could be obtained when modified TC thickness combined with the gallbladder abnormalities [ 20 , 21 , 27 , 28 ]. Furthermore, the combination of the modified TC sign, gallbladder classification scheme and GGT level with a cut off-value of 188 IU/L could yielded the sensitivity of 100.0% in the diagnosis of BA among infants less than 30 days [ 29 ].…”

Section: Conventional Ultrasoundmentioning

confidence: 99%

“…The presence of enlarged hepatic hilar LN, which was defined as the LN located at the porta hepatis and around the hepatoduodenal ligament ( Figure 4 ), is also useful for the diagnosis of BA [ 28 ]. The optimal cutoff value was 6.0 mm for the length of LN in the identification of BA, which yielded a sensitivity and specificity of 91.1% and 82.9%, respectively.…”

Section: Conventional Ultrasoundmentioning

confidence: 99%

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Ultrasound for the Diagnosis of Biliary Atresia: From Conventional Ultrasound to Artificial Intelligence

Zhou

2021

Diagnostics

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Biliary atresia is an aggressive liver disease of infancy and can cause death without timely surgical intervention. Early diagnosis of biliary atresia is critical to the recovery of bile drainage and long-term transplant-free survival. Ultrasound is recommended as the initial imaging strategy for the diagnosis of biliary atresia. Numerous ultrasound features have been proved helpful for the diagnosis of biliary atresia. In recent years, with the help of new technologies such as elastography ultrasound, contrast-enhanced ultrasound and artificial intelligence, the diagnostic performance of ultrasound has been significantly improved. In this review, various ultrasound features in the diagnosis of biliary atresia are summarized. A diagnostic decision flow chart for biliary atresia is proposed on the basis of the hybrid technologies, combining conventional ultrasound, elastography and contrast-enhanced ultrasound. In addition, the application of artificial intelligence in the diagnosis of biliary atresia with ultrasound images is also introduced.

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Hepatic subcapsular or capsular flow in biliary atresia: is it useful imaging feature after the Kasai operation?

et al. 2020

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Enlarged hepatic hilar lymph node: an additional ultrasonographic feature that may be helpful in the diagnosis of biliary atresia

Cited by 12 publications

References 18 publications

Gamma‐Glutamyl Transferase Combined With Conventional Ultrasound Features in Diagnosing Biliary Atresia

Gamma‐Glutamyl Transferase Combined With Conventional Ultrasound Features in Diagnosing Biliary Atresia

Ultrasound for the Diagnosis of Biliary Atresia: From Conventional Ultrasound to Artificial Intelligence

Hepatic subcapsular or capsular flow in biliary atresia: is it useful imaging feature after the Kasai operation?

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