Dao Chen Lin1, Kun Yu Wu2, Fang Ju Sun3, Chun Chao Huang4, Tung Hsin Wu5, Shin Lin Shih6, Pei Shan Tsai7. 1. Department of Radiology, Taipei Veterans General Hospital, Taipei City 11217, Taiwan, ROC; Division of Endocrine and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei City 11217, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei City 11221, Taiwan, ROC. 2. Department of Medical Imaging, Chi Mei Medical Center, Tainan City 71004, Taiwan, ROC. 3. Mackay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan, ROC; Department of Medical Research, MacKay Memorial Hospital, Tamsui Branch, New Taipei City 25160, Taiwan, ROC. 4. Mackay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan, ROC; Department of Radiology, MacKay Memorial Hospital, Taipei City 10449, Taiwan, ROC; Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan, ROC. 5. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City 11221, Taiwan, ROC. 6. Department of Radiology, MacKay Memorial Hospital, Taipei City 10449, Taiwan, ROC; Department of Radiology, Taipei Medical University, Taipei City 11031, Taiwan, ROC. 7. Mackay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan, ROC; Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan, ROC; Department of Radiology, MacKay Memorial Hospital, Taipei City 10449, Taiwan, ROC. Electronic address: purify.5372@mmh.org.tw.
Abstract
PURPOSE: Biliary atresia is a life-threatening disease that needs early diagnosis and management. Recently, MRI images have been used for the diagnosis of biliary atresia with improved accuracy of diagnosis when other imaging modalities such as ultrasonography are equivocal. This study aimed to evaluate the juxta-hilar extrahepatic biliary tree using MRI images to determine a quantitative value for diagnosing biliary atresia. MATERIALS AND METHODS: This retrospective study was approved by the Ethical Committee at Mackey Memorial Hospital (IRB Number: 15MMHIS149e). Between January 2010 and December 2015, twenty-five patients with surgically confirmed biliary atresia were enrolled (age 18-65 days). Another 25 patients with clinically or surgically diagnosed idiopathic neonatal hepatitis (age 6-64 days) and 20 patients with non-hepatobiliary disease (age 6-65 days) were considered control group and normal subjects, respectively. The diameter of the enlarged, T2-hyperintense structure was measured using MRI images by two radiologists both blinded. The cut-off value for a biliary atresia diagnosis was obtained by area under the curve analysis. RESULTS: The diameter of the T2-hyperintense structure at porta hepatis in biliary atresia (4.79 ± 1.14 mm) is larger than in idiopathic neonatal hepatitis (1.72 ± 0.42 mm) or in non-hepatobiliary disease (1.72 ± 0.35 mm) (p < 0.05). The optimum cut-off value for diagnosing biliary atresia was 3.1 mm with 98% sensitivity and 98% specificity. CONCLUSION: The value of the enlarged, T2-hyperintense structure measured on MRI images was significantly increased in biliary atresia and may be useful in diagnosing biliary atresia.
PURPOSE:Biliary atresia is a life-threatening disease that needs early diagnosis and management. Recently, MRI images have been used for the diagnosis of biliary atresia with improved accuracy of diagnosis when other imaging modalities such as ultrasonography are equivocal. This study aimed to evaluate the juxta-hilar extrahepatic biliary tree using MRI images to determine a quantitative value for diagnosing biliary atresia. MATERIALS AND METHODS: This retrospective study was approved by the Ethical Committee at Mackey Memorial Hospital (IRB Number: 15MMHIS149e). Between January 2010 and December 2015, twenty-five patients with surgically confirmed biliary atresia were enrolled (age 18-65 days). Another 25 patients with clinically or surgically diagnosed idiopathic neonatal hepatitis (age 6-64 days) and 20 patients with non-hepatobiliary disease (age 6-65 days) were considered control group and normal subjects, respectively. The diameter of the enlarged, T2-hyperintense structure was measured using MRI images by two radiologists both blinded. The cut-off value for a biliary atresia diagnosis was obtained by area under the curve analysis. RESULTS: The diameter of the T2-hyperintense structure at porta hepatis in biliary atresia (4.79 ± 1.14 mm) is larger than in idiopathic neonatal hepatitis (1.72 ± 0.42 mm) or in non-hepatobiliary disease (1.72 ± 0.35 mm) (p < 0.05). The optimum cut-off value for diagnosing biliary atresia was 3.1 mm with 98% sensitivity and 98% specificity. CONCLUSION: The value of the enlarged, T2-hyperintense structure measured on MRI images was significantly increased in biliary atresia and may be useful in diagnosing biliary atresia.