Objective differential characteristics of cystic biliary atresia and choledochal cysts in neonates and young infants: sonographic findings.
OBJECTIVE
To prospectively evaluate the objective differential characteristics between cystic biliary atresia and choledochal cysts on sonography among neonates and young infants.


METHODS
Twenty-three patients who had sonographic findings of a portal cyst and a final diagnosis were included. Their final diagnoses were cystic biliary atresia in 12 patients and choledochal cysts in 11. All of them underwent detailed sonographic scanning. Data for cystic biliary atresia and choledochal cyst groups were compared by the χ(2) test for categorical variables and an unpaired t test for continuous variables.


RESULTS
The triangular cord sign was detected in 11 patients in the atresia group but in none in the cyst group (P < .001). Nine of 11 patients in the cyst group had dilatation of intrahepatic bile ducts, whereas none in the atresia group had that feature (P < .001). Sonography also showed sludge deposits in the cysts in 6 of 11 patients in the cyst group, whereas none in the atresia group had sludge deposits (P = .005). The mean width and length of the cysts in the cyst group were significantly larger than those in the atresia group (P< .05 for both). The mean hepatic artery diameter was significantly larger in the atresia group than in the cyst group (P < .001). The difference in gallbladder abnormalities between the atresia (n = 11) and cyst (n = 0) groups was also significant (P < .001). When all specific sonographic features were used, all patients were correctly classified into the atresia and cyst groups.


CONCLUSIONS
The triangular cord sign, intrahepatic bile duct dilatation, and echoic cysts might be regarded as objective sonographic features for differentiating cystic biliary atresia and choledochal cysts. Other sonographic features might be very supportive.
Department of Ultrasonics, GuangzhouWomen’s and Children’s Medical Center, Guangzhou, China.
Lu-Yao
LY
Zhou
Bu-Yun
BY
Guan
Le
L
Li
Zuo-Feng
ZF
Xu
Chang-Ping
CP
Dai
Wei
W
Wang
Hui-Min
HM
Xia
Xiao-Yan
XY
Xie
D001656:Biliary Atresia / Q000000981:diagnostic imaging*; D015529:Choledochal Cyst / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*