Recent advances in the use of ultrasound and related techniques in diagnosing and predicting outcomes in biliary atresia

Dike, Peace N.; Mahmood, Nadia; Harpavat, Sanjiv

doi:10.1097/mop.0000000000001048

Cited by 6 publications

(6 citation statements)

References 33 publications

(56 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a non-invasive tool, the abdominal ultrasound has been widely used to help evaluate infants for BA ( 27 ), but few studies investigated the correlation between ultrasound signs and CJ post-KP. This study emphasized the importance of the thickness of the fibrous portal plate and LSM value, which were collected by ultrasound for this novel prediction model.…”

Section: Discussionmentioning

confidence: 99%

A Novel Model for Predicting the Clearance of Jaundice in Patients With Biliary Atresia After Kasai Procedure

Zhang

Wang

et al. 2022

Front. Pediatr.

View full text Add to dashboard Cite

BackgroundThe failed clearance of jaundice (CJ) in patients with biliary atresia (BA) after the Kasai procedure (KP) often leads to a shorter native liver survival (NLS) time and earlier liver transplantation. We aimed to investigate risk factors of failed CJ and establish a novel nomogram model to predict the status of CJ.MethodsWe retrospectively reviewed institutional medical records from January 2015 to April 2020 and enrolled BA patients post-KP, randomly divided into training and testing cohorts at a ratio of 7:3, and further subdivided into cleared and uncleared jaundice groups. Univariate and multiple logistic regression analyses were used to select risk factors to establish the nomogram in the training cohort. The performance of the nomogram was evaluated by calculating the areas under the receiver operating curve (AUC) in both cohorts.ResultsThis study included 175 BA patients post-KP. After univariate and multiple logistic regression analyses, Cytomegalovirus IgM +ve associated BA (OR = 3.38; 95% CI 1.01–11.32; P = 0.04), ln γ-glutamyl transpeptidase (GGT) (OR = 0.41; 95% CI 0.22–0.80; P = 0.009), thickness of the fibrous portal plate (OR = 0.45; 95% CI 0.27–0.76; P = 0.003), liver stiffness measurement (LSM) (OR = 1.19; 95% CI 1.06–1.34; P = 0.002), and multiple episodes of cholangitis (OR = 1.65; 95% CI 1.13–2.41; P = 0.01) were identified as independent risk factors of unsuccessful CJ to construct the nomogram. The receiver operating characteristic curve (ROC) analysis suggested good nomogram performance in both the training (AUC = 0.96) and testing cohorts (AUC = 0.91).ConclusionOur nomogram model including several risk factors effectively predicts CJ in patients post-KP, which could aid in clinical decision-making.

show abstract

Section: Discussionmentioning

confidence: 99%

A Novel Model for Predicting the Clearance of Jaundice in Patients With Biliary Atresia After Kasai Procedure

Zhang

Wang

et al. 2022

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…Elastographic or magnetic resonance assessment of liver and/or spleen stiffness is emerging noninvasive modalities that may predict PHTN in children. [23][24][25] Calculated scores such as the aspartate-to-platelet ratio index (APRi), GGT-to-platelet ratio, and fibrosis-4 (Fib-4) require only standard laboratory values. [26][27][28][29][30] Ascites, Spontaneous Bacterial Peritonitis, and Hepatorenal Syndrome in Children Pathophysiology of Ascites, SBP, and HRS Multiple forces contribute to the development of ascites in cirrhosis.…”

Section: Diagnosis Of Portal Hypertension In Childrenmentioning

confidence: 99%

“…Elastographic or magnetic resonance assessment of liver and/or spleen stiffness is emerging noninvasive modalities that may predict PHTN in children. 23 24 25 Calculated scores such as the aspartate-to-platelet ratio index (APRi), GGT-to-platelet ratio, and fibrosis-4 (Fib-4) require only standard laboratory values. 26 27 28 29 30…”

Section: Diagnosis Of Portal Hypertension In Childrenmentioning

confidence: 99%

Beyond Varices: Complications of Cirrhotic Portal Hypertension in Pediatrics

et al. 2022

View full text Add to dashboard Cite

Complications of cirrhotic portal hypertension (PHTN) in children are broad and include clinical manifestations ranging from variceal hemorrhage, hepatic encephalopathy (HE), ascites, spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS) to less common conditions such as hepatopulmonary syndrome, portopulmonary hypertension, and cirrhotic cardiomyopathy. The approaches to the diagnosis and management of these complications have become standard of practice in adults with cirrhosis with many guidance statements available. However, there is limited literature on the diagnosis and management of these complications of PHTN in children with much of the current guidance available focused on variceal hemorrhage. The aim of this review is to summarize the current literature in adults who experience these complications of cirrhotic PHTN beyond variceal hemorrhage and present the available literature in children, with a focus on diagnosis, management, and liver transplant decision making in children with cirrhosis who develop ascites, SBP, HRS, HE, and cardiopulmonary complications.

show abstract

“…Based on the IOC ndings, children are divided into BA group and non-BA group. Abnormal gallbladder was de ned as stiff, small, irregular, or absent gallbladder on abdominal ultrasound [8,20] . The HSST sign was de ned as the presence of three or more branches in a large tortuous spiderlike vascular plexuses distributed on the liver surface in a decentralized (radial branches arising from more than one central point, but close to each other to form a spiderlike sign) (Fig.…”

Section: Data Collectionmentioning

confidence: 99%

Intraoperative hepatic subcapsular spider-like telangiectasia sign for the definitive diagnosis of biliary atresia

Zhang

Jin

Tang

et al. 2022

Preprint

View full text Add to dashboard Cite

Objective: To evaluate the accuracy of intraoperative hepatic subcapsular spider-like telangiectasia (HSST) sign for differentiating biliary atresia (BA) from other causes of hepatic cholestasis.Methods: The data of 69 patients with jaundice treated from January 2018 to December 2021 were retrospectively analyzed. Based on intraoperative cholangiography (IOC), the patients were divided into two groups: BA group (n = 49) and non-BA group (n = 20). The biochemistry tests, liver ultrasound, liver stiffness and HSST sign of the two groups were compared.Results: The incidence of abnormal gallbladder, elevated γ-glutamyl transpeptidase (γ-GGT) >182.0U/L and abnormal liver stiffness (>6.4kPa) in BA group were significantly higher than those in non-BA group (P < 0.001). The HSST sign was present in all BA patients and not found in non-BA group. The area under receiver operating curve of direct bilirubin, γ-GGT, abnormal gallbladder, liver stiffness value and HSST sign were 0.53, 0.84, 0.78, 0.96, and 1.00, respectively. The sensitivity, specificity, PPV and NPV of HSST sign in the diagnosis of BA were all 100%.Conclusion: Presence of HSST sign on diagnostic laparoscopy or laparotomy is highly suggestive of BA. If the HSST sign is present on laparoscopy, then IOC can be avoided.

show abstract

Recent advances in the use of ultrasound and related techniques in diagnosing and predicting outcomes in biliary atresia

Cited by 6 publications

References 33 publications

A Novel Model for Predicting the Clearance of Jaundice in Patients With Biliary Atresia After Kasai Procedure

A Novel Model for Predicting the Clearance of Jaundice in Patients With Biliary Atresia After Kasai Procedure

Beyond Varices: Complications of Cirrhotic Portal Hypertension in Pediatrics

Intraoperative hepatic subcapsular spider-like telangiectasia sign for the definitive diagnosis of biliary atresia

Contact Info

Product

Resources

About