New Diagnostic Approach in Biliary Atresia with Emphasis on Ultrasonographic "Triangular Cord" Sign |
New Diagnostic Approach in Biliary Atresia with Emphasis on Ultrasonographic "Triangular Cord" Sign |
박우현; 최순옥 |
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Abstract |
Infantile cholestatic jaundice;
characterized by persistent conjugated hyperbilirubinemia; has remained a major diagnostic challenge despite continual improvement of diagnostic tests and increasing knowledge regarding its pathogenesis. It is important that the infants with biliary atresia(BA) should be identified early; as the success of the Kasai procedure is inversely related to age and is greatest if performed during the first two months of life(Kasai et al; 1968; Karrer et al’ 1990; ?hi & Ibrahim; 1995). No single test or imaging modality can reliably define the causes of infantile cholestasis. Ultrasonography has played a role in screening infantile cholestasis; mainly focusing on shape and/or contractility of the gall bladder (Abramson et al; 1982; Kirks et al; 1984; Altman & Abramson;1985; Brun et al; 1985; Green & Carroll et al; 1986; Weinberger et al; 1987; Ikeda et al; 1989). Lately the authors reported that ultrasonographic triangular code(TC) which represents a cone-shaped fibrotic mass cranial to the bifurcation of the portal vein in BA infants; was very useful in the diagnosis of BA(Choi et al; 1996; Choi et al; 1997).
The aim of this paper is to reassess the
role of ultrasonography(US); hepatobiliary scintigraphy(HS); and liver needle biopsy(NBx) with particular emphasis on ultrasonographic TC in differentiating BA from other causes of intrahepatic cholestasis and to propose a new diagnostic approach in the evaluation of infantile cholestasis.
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