2021 Volume 57 Issue 5 Pages 844-849
Purpose: The aim of this study was to evaluate the feasibility and efficacy of ultrasonographic shear wave elastography (SWE) for the early diagnosis of biliary atresia (BA) during the neonatal period.
Methods: We retrospectively reviewed the cases of 26 patients with hyperbilirubinemia (>1.0 mg/dl direct bilirubin) and who underwent ultrasonographic SWE during their neonatal period at our institute. We compared hepatobiliary laboratory biomarkers and ultrasonographic findings, such as severe atrophic gallbladder, triangular cord signs, and liver elasticity, measured by SWE between patients with and without BA. Receiver operating characteristic (ROC) analysis was carried out to evaluate the diagnostic performance of liver elasticity.
Results: Among the 26 patients, 10 were diagnosed as having BA. Of the hepatobiliary laboratory biomarkers, only the gamma-glutamyl transferase level was significantly higher in patients with BA than in those without BA (p = 0.004). There were significant differences in the positive findings of triangular cord signs (p = 0.014) and liver elasticity measured by SWE (p = 0.004). According to the receiver operating characteristic curve analysis, liver elasticity demonstrated a sensitivity of 90%, a specificity of 75%, a positive predictive value of 69.2%, and a negative predictive value of 92.3%. The sensitivity and negative predictive value of liver elasticity were relatively higher than the other ultrasonographic results.
Conclusions: The results of our study suggest that early diagnosis of biliary atresia using SWE during the neonatal period is feasible and useful.
