MDCT of biliary cysts in children with biliary atresia: clinical associations and pathologic correlations.
OBJECTIVE
To evaluate the association of biliary cyst formation with cholangitis, portoenterostomy, biochemical abnormalities, using multidetector computed tomography (MDCT) and pathologic findings of end-stage liver disease.


METHODS
We retrospectively reviewed the 42 MCDT studies, clinical history and laboratory findings of 36 children with biliary atresia.


RESULTS
Biliary cysts were detected in 58% of the patients on MDCT images. The cysts were not associated with cholangitis, portoenterostomy surgery, or biochemical abnormality. Hepatic artery anomaly was also common in our series (25%) and more common in patients with biliary cysts which was statistically significant (P < 0.05). Eighteen livers were available for pathologic examination. The only statistically significant finding between the patients with and without biliary cysts were biliary epithelial damage and inflammatory reaction around the cysts which were common in the patients with biliary cysts (P < 0.05).


CONCLUSIONS
The damage to the bile duct epithelium and inflammatory reaction around the biliary epithelium support the theory of obstruction and bile leaks in the etiogenesis of biliary cysts. This is the first report of the association between hepatic artery variations and the biliary cysts; this may be important in pretransplant evaluation.
Ulu
Esra Meltem Kayahan
EM
Department of Radiology, Başkent University School of Medicine, Ankara, Turkey. emkayahanulu@yahoo.com
Dönmez
Fuldem Yildirim
FY
Haberal
Nihan
N
Durukan
Elif
E
Oztürk
Ahmet
A
Bayrak
Ahmet
A
Coşkun
Mehmet
M
D001201:Ascites / Q000000981:diagnostic imaging; D001652:Bile Ducts / Q000473:pathology; D001656:Biliary Atresia / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002648:Child; D002758:Cholangiography / Q000379:methods; D006801:Humans; D008099:Liver / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D016031:Liver Transplantation; D011379:Prognosis; D012189:Retrospective Studies; D013163:Splenomegaly / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*