| Making the diagnosis of biliary atresia using the triangular cord sign and gallbladder length. | |
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MedLine Citation:
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PMID: 10663514 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To evaluate the accuracy and utility of the triangular cord sign and gallbladder length in diagnosing biliary atresia by sonography. MATERIALS AND METHODS: Sixty fasted infants with cholestatic jaundice aged 2-12 weeks were examined sonographically using a 5-10 MHz linear array transducer, focusing on the triangular cord sign (as described by Choi et al. [1]), the gallbladder, and ducts. The triangular cord is defined as a triangular or tubular echogenic density seen immediately cranial to the portal vein bifurcation; it represents the fibrotic remnant of the obliterated cord in biliary atresia. The findings were blinded to blood chemistry, (99 m)Tc-DISIDA hepatobiliary scintigraphy, and liver biopsy. Diagnosis of biliary atresia was confirmed at surgery and histology. Non-biliary atresia infants resolved medically. Comparative charges of the various investigations was made. RESULTS:++ Twelve infants had biliary atresia, and ten demonstrated a definite triangular cord. The two false-negatives had small or nonvisualized gallbladders. No false-positives were recorded. Gallbladder length ranged from 0-1.45 cm with a mean of 0. 52 cm in biliary atresia compared to a mean of 2.39 cm in nonbiliary atresia infants. (99 m)Tc-DISIDA hepatobiliary scintigraphy showed no excretion (false-positive) in 23 % of nonbiliary atresia cases. Scintigraphy and liver biopsy charges were 2 and 6 times that of sonography, respectively. CONCLUSION: The triangular cord sign and gallbladder length together are noninvasive, inexpensive, and very useful markers for biliary atresia. |
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Authors:
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A P Tan Kendrick; K B Phua; B C Ooi; R Subramaniam; C E Tan; A S Goh |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatric radiology Volume: 30 ISSN: 0301-0449 ISO Abbreviation: Pediatr Radiol Publication Date: 2000 Feb |
Date Detail:
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Created Date: 2000-06-01 Completed Date: 2000-06-01 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0365332 Medline TA: Pediatr Radiol Country: GERMANY |
Other Details:
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Languages: eng Pagination: 69-73 Citation Subset: IM |
Affiliation:
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Department of Diagnostic Imaging, Kandang Kerbau Women's and Children's Hospital, 100 Bukit Timah Road, Singapore. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Bile Ducts, Extrahepatic
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abnormalities*,
ultrasonography Biliary Atresia / complications, diagnosis, ultrasonography* Biopsy Cholestasis / etiology Diagnosis, Differential Female Gallbladder / abnormalities*, ultrasonography Humans Infant Infant, Newborn Jaundice, Neonatal / etiology Male Prospective Studies Sensitivity and Specificity |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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