Articles Vol. 64 No. 5 23/08/2023

4. ULTRASONOGRAPHY CHARACTERISTICS OF 54 PATIENTS UNDER 4 MONTHS OLD SUSPECTED OF BILIARY ATRESIA AND UNDERWENT OPERATION AT THE NATIONAL HOSPITAL OF PEDIATRIC

Nguyen Duc Hanh1,2, Tran Phan Ninh1,2, Vu Dang Luu3,4, Nguyen Quynh Mai1,2
1 Vietnam National Children’s Hospital
2 Bệnh viện Nhi Trung ương
3 Bach Mai Hospital
4 Bệnh viện Bạch Mai
Corresponding author: ninh98@gmail.com
DOI: 10.52163/yhc.v64i5.760
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Keywords
Biliary atresia, ultrasonography, elasto graphy, doppler ultrasonography.
Abstract

Objectives: Describe the characteristics of ultrasonography images of 54 patients under 4 months old with symptoms suspected of cholestasis and underwent the operation at the National Hospital of Pediatrics from January 2021 to May 2023.

Methods: A cross-sectional study was carried out on 54 patients under 120 days old suspected of cholestasis and had the final diagnosis of biliary atresia or not due to exploratory surgery associated with cholangiogram and had pathology results diagnosis. All patients had been performing conventional and Doppler ultrasonography, Elastography due to BA protocol pre-operation.

Results: 39/54 cases were diagnosed with BA Average age of BA is 63 days; boy/girl = 1.17; direction Bil 107 µmol/l; direction Bil/ indirection Bil = 59%; average GGT is 629 UI/l. 6/39 patients of BA group (15%) have not gall bladder; 27/39 patients have gall bladder length </=15mm (69%; p=0.00; OR=31.5), irregular gall bladder wall in 27/33 patients (82%; p=0.00; OR=63), abnormal length/width gall bladder in 8/33 patients (24%) – seen more in non BA group with 10/15 patients (67%; p<0.05; OR=0.16), gall bladder non or weak contraction 21/33 patients in BA group (64%, p=0.27; OR =2), average thickening of a triangular cord of BA group is 3.5mm (p=0.000), average elasto value 10.3 kPa (p=0.001), HSF positive in 94.9% (p=0.00; OR=37), average right liver length in BA group 77.5mm (p=0.11), left liver 55.7mm (p=0.001), proper hepatic artery diameter 2.3mm (p=0.262), Vmax is 66cm/s (p=0.495), RI 0.75 (p=0.074); the right hepatic artery diameter 1.7mm (p=0.023), portal vein diameter 4.6mm (p=0.429), Vmax 25.2cm/s (p=0.702).

Conclusion: The thickening of the liver hilar triangular cord, gall bladder length </=15mm, irregular gall bladder wall, elastic value, HSF and the length of the left liver, and right hepatic artery diameter all have the statistically significant difference from BA and non BA.

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