Prenatal sonographic diagnosis of biliary tract malformations

Abstract

Congenital anomalies of the biliary tract include a variety of pathologic conditions, such as biliary atresia, choledochal cysts, gallbladder agenesis, congenital cholelithiasis, and gallbladder duplication. Although most of these malformations are rare and benign conditions, they may occasionally represent a major threat to extrauterine life. Visualization of a normal‐sized gallbladder should be a mandatory component of the second‐trimester anomaly ultrasound scan. Advances in prenatal sonography enable the detection of biliary tract congenital malformations. In this review, we discuss the detection rates, sonographic features, and prognosis of the most frequently prenatally diagnosed biliary tract malformations.

Key imaging features for differentiating cystic biliary atresia from choledochal cyst: prenatal ultrasonography and postnatal ultrasonography and MRI

“…In addition, on prenatal studies, the cysts in the CC group were all larger than 1 cm and showed a tendency for gradual growth after birth, while the cyst in the cBA group for which information was available was smaller than 1 cm and stable in size. Other studies also mentioned that the cyst size in infants with cBA was stable during follow-up in the prenatal period [20,27,28] and smaller than that reported in a postnatal study [4], even though the size itself varied considerably across infants (0.5-4.0 cm). Obliteration between the intrahepatic and extrahepatic bile ducts in BA, rather Fig.…”

“…The morphology of GB plays an important role in both prenatal and postnatal imaging. A small or nonvisible GB in the second trimester increases the suspicion of BA on prenatal US [28,29].…”

Differentiation of cystic biliary atresia and choledochal cysts using prenatal ultrasonography

“…Previous studies proposed that cyst communication with the GB may facilitate the diagnosis of CC [ 18 ]. In the 35 CC cases analyzed herein, a GB-cyst connection was observed in 32 cases (91.4%), except in three cases where the cysts were relatively long (≥4.3 cm).…”

Choledochal cyst theories going pear‐shaped? Evolution of choledochal cyst during intrauterine life in a case evaluated using magnetic resonance imaging and postnatal outcomes

“…The presence of a cyst in the right upper abdomen and small gallbladder suggests the diagnosis of congenital anomalies of the biliary tract. 12 However, the association of small gallbladder and CC has not been described in intrauterine life. The differential diagnosis of CC and biliary atresia may be difficult during pregnancy.…”