title: Diffusion Tensor Imaging for Evaluating Biliary Atresia in Infants and Neonates.
abstract: BACKGROUND
  Preliminary studies have shown that diffusion tensor imaging (DTI) is helpful in evaluating liver disorders. However, there is no published literature on the use of DTI in the diagnosis of biliary atresia (BA). This study aimed to investigate the diagnostic value of the liver average apparent diffusion coefficient (ADC) and fractional anisotropy (FA) measured using DTI for BA in neonates and infants.
  
  
  METHODS
  Fifty-nine patients with infant jaundice were included in this study. DTI was performed with b factors of 0 and 1000 s/mm2. Liver fibrosis in the BA group was determined and graded (F0, F1, F2, F3, F4) based on the pathological findings. Statistical analyses were performed to determine the diagnostic accuracy of DTI for BA.
  
  
  RESULTS
  The ADC value was significantly lower in the BA group [(1.262±0.127)×10-3 mm2/s] than in the non-BA group [(1.430±0.149)×10-3 mm2/s, (P<0.001)]. The area under the receiver operating characteristic curve was 0.805±0.058 (P<0.001) for ADC. With a cut-off value of 1.317×10-3 mm2/s, ADC achieved a sensitivity of 75% and a specificity of 81.5% for the differential diagnosis of BA and non-BA. In the BA group, the ADC value was significantly correlated with fibrotic stage. Further analysis showed that the ADC value of stage F0 was significantly higher than that of stages F1, F2, F3 and F4, whereas there were no significant differences among stages F1, F2, F3 and F4.
  
  
  CONCLUSIONS
  Hepatic ADC measured with DTI can be used as an adjunct to other noninvasive imaging methods in the differential diagnosis of BA and non-BA. ADC was helpful in detecting liver fibrosis but not in differentiating the fibrotic grades.
authors.affiliation: Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Jinhua
authors.identifier: http://orcid.org/0000-0001-7971-8936
authors.initials: J
authors.lastname: Cai
authors.affiliation: Department of Pathology, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Helin
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Longlun
authors.initials: L
authors.lastname: Wang
mesh_terms: D001656:Biliary Atresia / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male