A novel prediction tool based on shear wave elastography, gallbladder ultrasound, and serum biomarkers for the early diagnosis of biliary atresia in infants younger than 60 days old

Quantitative Imaging in Medicine and Surgery

article

Hualin Yan¹  Juxian Liu¹  Shuguang Jin²  Lanxin Du³  Qi Wang²  Yan Luo¹ 

[1] Department of Medical Ultrasound, West China Hospital , Sichuan University;Department of Pediatric Surgery, West China Hospital , Sichuan University;Department of Ultrasound, West China Second University Hospital , Sichuan University

关键词: Biliary atresia (BA);    nomogram;    diagnosis;    ultrasound (US);    shear wave elastography (SWE);   

DOI  :  10.21037/qims-22-324

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: Early Kasai surgery before 60 days of life results in better clinical outcomes in patients with biliary atresia (BA). We aimed to develop and validate a prediction tool for the early diagnosis of BA in infants younger than 60 days old. Methods: This prospective study recruited consecutive infants younger than 60 days old with conjugated hyperbilirubinemia who were evaluated with an ultrasound (US) scan, including B-mode US with color Doppler flow imaging (CDFI) features and liver two-dimensional shear wave elastography (2D SWE), from March 2017 to July 2021. The reference standard for diagnosis was intraoperative cholangiography, liver biopsy, or the resolution of jaundice. Area under the receiver operating characteristic curve (AUC) analysis, logistic regression analysis, and establishment of a nomogram were performed. Results: A total of 174 patients (mean age, 46 days), including 87 infants with BA and 87 non-BA cholestatic infants, were included in the study. The established nomogram based on gallbladder (GB) abnormality, liver 2D SWE, and serum γ-glutamyl transferase (GGT) and alanine aminotransferase (ALT) had an AUC of 0.99 [95% confidence interval (CI): 0.94–1.00], a sensitivity of 92%, and a specificity of 100%. The nomogram in the validation cohort also had good diagnostic performance in the diagnosis of BA, with an AUC of 0.98 (95% CI: 0.95–1.00). Conclusions: The new prediction tool had a good diagnostic performance in the early prediction of BA in infants younger than 60 days old and will facilitate timely Kasai surgery.

【 授权许可】

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