Identification of biliary atresia and infantile hepatitis syndrome by hilar bile duct usingultrasonography

LIANG Jia-yi; WU Li-li; REN Jie; FENG Shan-shan; ZHENG Rong-qin

Abstract：Objective To investigate the clinical value of ultrasonographic ( US) features of hilar bile duct in dif-ferentiation between biliary atresia ( BA) and infantile hepatitis syndrome ( IHS) .Methods US images of hilar bile duct of 17 infants with BA and 33 infants with IHS were reviewed .Two US features including the display of hilar biliary lumen and the triangular cord ( TC) sign were assessed .Results The display of hilar biliary lumen , the positive rate of the tri-angular cord sign , as well as their combination showed a significant difference between BA and IHS groups ( P<0.05 ) . The display rate of the hilar biliary lumen in BA infants was lower than that in IHS infants .The display rate of the hilar biliary lumen was 4/17(23.5%) in BA, and 30/33(90.9%) in IHS.The positive rate of the TC sign in BA infants was higher than that in IHS infants .The positive rate of the TC sign was 7/17(41.2%) in BA, and 0/33(0) in IHS.There were 7 in 17 infants (41.2%) with poor display of hilar biliary lumen and positive TC sign in BA , whereas the proportion was 0 in IHS.While there were 30 in 33 infants (90.9%) with clear display of hilar biliary lumen and negative TC sign in IHS, whereas the proportion was 29.4% ( 5/17 ) in IHS.Conclusion Observation of lumen of hilar bile duct has great value in differentiation between BA and IHS .The display of hilar biliary lumen coupled with TC sign might be used to further differentiate BA from IHS .