Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Napolitano, M; Franchi-Abella, S; Damasio, MB; Augdal, TA; Avni, FE; Bruno, C; Darge, K; Ključevšek, D; Littooij, AS; Lobo, L; Mentzel, HJ; Riccabona, M; Stafrace, S; Toso, S; Woźniak, MM; Di, Leo, G; Sardanelli, F; Ording, Müller, LS; Petit, P.
Practical approach to imaging diagnosis of biliary atresia, Part 1: prenatal ultrasound and magnetic resonance imaging, and postnatal ultrasound.
Pediatr Radiol. 2021; 51(2):314-331
Doi: 10.1007/s00247-020-04840-9
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Riccabona Michael
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- Abstract:
- We present a practical approach to imaging in suspected biliary atresia, an inflammatory cholangiopathy of infancy resulting in progressive fibrosis and obliteration of extrahepatic and intrahepatic bile ducts. Left untreated or with failure of the Kasai procedure, biliary atresia progresses towards biliary cirrhosis, end-stage liver failure and death by age 3. Differentiation of biliary atresia from other nonsurgical causes of neonatal cholestasis is challenging because there is no single method for diagnosing biliary atresia, and clinical, laboratory and imaging features of this disease overlap with those of other causes of neonatal cholestasis. Concerning imaging, our systematic literature review shows that ultrasonography is the main tool for pre- and neonatal diagnosis. Key prenatal features, when present, are non-visualisation of the gallbladder, cyst in the liver hilum, heterotaxy syndrome and irregular gallbladder walls. Postnatal imaging features have a very high specificity when present, but a variable sensitivity. Triangular cord sign and abnormal gallbladder have the highest sensitivity and specificity. The presence of macro- or microcyst or polysplenia syndrome is highly specific but less sensitive. The diameter of the hepatic artery and hepatic subcapsular flow are less reliable. When present in the context of acholic stools, dilated intrahepatic bile ducts rule out biliary atresia. Importantly, a normal US exam does not rule out biliary atresia. Signs of chronic hepatopathy and portal hypertension (portosystemic derivations such as patent ductus venosus, recanalised umbilical vein, splenomegaly and ascites) should be actively identified for - but are not specific for - biliary atresia.
- Find related publications in this database (using NLM MeSH Indexing)
- Biliary Atresia - diagnostic imaging
- Child, Preschool - administration & dosage
- Cholestasis - administration & dosage
- Female - administration & dosage
- Humans - administration & dosage
- Hypertension, Portal - administration & dosage
- Infant - administration & dosage
- Infant, Newborn - administration & dosage
- Magnetic Resonance Imaging - administration & dosage
- Pregnancy - administration & dosage
- Ultrasonography - administration & dosage
- Ultrasonography, Prenatal - administration & dosage
- Find related publications in this database (Keywords)
- Biliary atresia
- Imaging
- Infant
- Magnetic resonance imaging
- Recommendations
- Review
- Ultrasound