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Diagnostic Value of Ultrasound Parameter in Neonatal Biliary Atresia Based on Histopathological Results (Ultrasound study of triangular cord sign and gallbladder abnormality)

Volume: 108  ,  Issue: 1 , September    Published Date: 14 September 2022
Publisher Name: IJRP
Views: 50  ,  Download: 29 , Pages: 316 - 322    
DOI: 10.47119/IJRP1001081920223874

Authors

# Author Name
1 Purbo Agus Sulistio
2 Lenny Violetta
3 Alphania Rahniayu

Abstract

Objective: Biliary atresia is an obliterative progressive disease that forms fibrotic tissue in the biliary tract in the neonatal phase. In some European countries, the reported incidence of biliary atresia varies between 1/14,000 and 1/20,000 live births. Ultrasound examination is the modality used to diagnose Biliary Atresia. Ultrasound assessed the sensitivity, specificity, and accuracy of the Triangular Cord Sign and gallbladder abnormality consisting of gallbladder contractility and wall echogenicity. We evaluated the diagnostic test results of Triangular Cord Sign and gallbladder contractility and wall echogenicity with ultrasound examination based on histopathological results of neonatal biliary atresia Material and Methods:This diagnostic test was performed retrospectively between January 2019 and December 2020 with consecutive sampling techniques. A total of 61 pediatric patients clinically diagnosed with biliary atresia underwent ultrasound examination of triangular cord sign and gall bladder abnormality examined by a pediatric radiologist. Histopathological results of liver biopsy specimens confirming biliary atresia were available for all those patients. Data were analysed to assess accuracy, sensitivity, specificity, PPV, and NPV of ultrasound compared with histopathology result Result: The Triangular Cord Sign sensitivity was found to be 70%, specificity 18.2%, PPV 79.5%, NPV 11.8%, and accuracy 60.7%. There was a significant relationship between Triangular Cord signs and histopathology. Gallbladder contractility parameter sensitivity was 76. %, specificity 18.2%, PPV 80.9%, NPV 14.3%, and accuracy 65.6%. However, there was no significant relationship between the histopathology results and the gallbladder wall's echogenicity, with a sensitivity of 70%, specificity of 18.2%, PPV of 79.5%, NPV of 11.8%, and accuracy of 60.7%.  Conclusion:The appearance of the triangular cord sign on ultrasonography has a significant relationship with the results of histopathology in biliary atresia

Keywords

  • biliary atresia
  • triangular cord sign
  • gallbladder contractility
  • gallblader wall echogenicity